| William Martin Bracken, DO | |
|
14365 Highway 16 W, De Kalb, MS 39328-7974 | |
| (601) 743-4626 | |
| (601) 743-2133 |
| Full Name | William Martin Bracken |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 31 Years |
| Location | 14365 Highway 16 W, De Kalb, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417969031 | NPI | - | NPPES |
| 00118406 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 15288 (Mississippi) | Secondary |
| 207Q00000X | Family Medicine | 15288 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Rush Foundation Hospital | Meridian, MS | Hospital |
| John C Stennis Memorial Hospital | De kalb, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bonita Emergency Group Llc | 3870933278 | 21 |
| Kemper Cah, Inc. | 5991985012 | 20 |
| Entity Name | Medical Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609820539 PECOS PAC ID: 9234043712 Enrollment ID: O20031118000855 |
| Entity Name | Rush Medical Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588625594 PECOS PAC ID: 2567368541 Enrollment ID: O20031210000541 |
| Entity Name | Laird Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821046798 PECOS PAC ID: 7214991769 Enrollment ID: O20050201000304 |
| Entity Name | Scott Regional Medical Center, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639367188 PECOS PAC ID: 0648366260 Enrollment ID: O20080423000448 |
| Entity Name | Kemper Cah, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346546306 PECOS PAC ID: 5991985012 Enrollment ID: O20110622000294 |
| Entity Name | Bonita Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992563969 PECOS PAC ID: 3870933278 Enrollment ID: O20240502001459 |
| Mailing Address | Practice Location Address |
|---|---|
| William Martin Bracken, DO 1314 19th Ave, Meridian, MS 39301-4116 Ph: (601) 703-4282 | William Martin Bracken, DO 14365 Highway 16 W, De Kalb, MS 39328-7974 Ph: (601) 743-4626 |
Patricia Dunlap, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 14365 Highway 16 W, De Kalb, MS 39328 Phone: 769-486-1000 Fax: 769-486-1099 | |
Anna Marie Hailey-sharp, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 14365 Highway 16 W, De Kalb, MS 39328 Phone: 601-743-4626 Fax: 601-743-2133 |