Howard L Bruckner, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

014605 Issued in GA

Practice address

909 15TH St
Augusta, GA 30901-2607

Phone

(706) 722-9601

NPI assigned

Nov 16, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1922289057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012607",
            "telephone_number": "706-722-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012607",
            "telephone_number": "706-722-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCKNER",
        "first_name": "HOWARD",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "014605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frankie Carroll Browning, LPC
• Shannon Leah Broxton, CRNA
• Christina Ramos Bruce, MD
• John-David Constantine Bruce
• Winston Clark Bruce, CRNA
• Cheries L Brule, P.T.
• Rebecca G Brumbeloe, MHS,OTR/L
• Ryan Thomas Brummond, MD
• Aida C Bruno, PHYSICAL THERAPIST
• Askiel Bruno, MD

• Ophthalmology Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.