ALEX J BRADDOCK


Address: 175 W Broadway, Lincoln, ME 04457-4000
Phone: 2077946700

ALEX J BRADDOCK (NPI# 1437533460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437533460
Entity Type Individual
Full Name ALEX J BRADDOCK
Credential PA-C
Practice Address 175 W Broadway
Lincoln
ME 04457-4000
Mailing Address 175 W Broadway
Po Box 99
Lincoln
ME 04457-4000
Practice Telephone 2077946700
Practice Fax Number 2077946777
Mailing Telephone 2077946700
Mailing Fax Number 2077946777
Enumeration Date 2015-07-20
Last Update Date 2015-07-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant ME Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 175 W BROADWAY
City LINCOLN
State ME
Zip Code 04457-4000

Providers in the same location

NPI Name Taxonomy Address Enumeration
1023005378 Dominick Olivo Podiatrist 175 W Broadway, Lincoln, ME 04457-4000 2005-10-03
1871088914 Amber Lee Willey Nurse Practitioner 175 W Broadway, Lincoln, ME 04457-4000 2018-06-29
1235623307 Oluwapelumi Aderonke Adeloye Dentist 175 W Broadway, Lincoln, ME 04457-4000 2018-06-21
1447780002 Jamie Perry Nurse Practitioner 175 W Broadway, Lincoln, ME 04457-4000 2017-06-15
1023550399 Mark Kent Psychologist 175 W Broadway, Lincoln, ME 04457-4000 2016-11-17
1942679899 Laycee Duhaime Nurse Practitioner 175 W Broadway, Lincoln, ME 04457-4000 2015-09-22
1417399205 Jodie L Perfect Nurse Practitioner 175 W Broadway, Lincoln, ME 04457-4000 2013-07-23
1154764975 Katie Marie Adams Family Medicine 175 W Broadway, Lincoln, ME 04457 2013-04-11
1467895201 Diksha Malik Family Medicine 175 W Broadway, Lincoln, ME 04457 2013-04-11
1124371778 Kenneth B Liberty Psychologist 175 W Broadway, Lincoln, ME 04457-4000 2012-10-19
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1467928317 Carlos Lopez & Associates LLC Counselor 213 W. Broadway, Lincoln, ME 04457 2018-10-18
1902303142 Jennifer Harvey Speech-Language Pathologist 36 Workman Terrace Street, Lincoln, ME 04457 2018-04-12
1255714275 Jill Bouchard Registered Nurse 313 Enfield Rd, Lincoln, ME 04457 2015-07-08
1346594769 Total Renal Care Inc Clinic/Center 250 Enfield Rd, Lincoln, ME 04457 2012-11-07
1932429743 Anne Marie Osolinski Counselor 8 Fleming Street, Suite C, Lincoln, ME 04457 2010-06-03
1477886711 Lakeview Afch Inc Custodial Care Facility 10 E Broadway, Lincoln, ME 04457 2009-09-17
1326273418 Colonial Healthcare Assisted Living Facility 36 Workman Terrace, Lincoln, ME 04457 2009-05-19
1730346743 Mark B Weatherbee Od Optometrist 26 Enfield Road, Lincoln, ME 04457 2008-05-19
1396948139 Alfred H. Vandine Jr. Counselor 313 Enfield Road, Lincoln, ME 04457 2007-06-08
1902024870 Mary Catherine Goolsby Social Worker 313 Enfield Rd., Lincoln, ME 04457 2007-04-23
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1619580156 Alana M Oster Physician Assistant 129 Chapel St, Lincoln, RI 02865-2119 2020-08-25
1871143891 Ashley Moreau Physician Assistant 4 Lauretta Ln, Lincoln, RI 02865-1338 2019-09-12
1013574862 Erin Grace Dragoo Physician Assistant 2310 Wesley Dr, Lincoln, NE 68512-3704 2019-05-28
1629535521 Jason Theodore Physician Assistant 4615 Meredeth St Apt 6, Lincoln, NE 68506-4973 2019-02-27
1144674276 Austin Bryce Henslee Physician Assistant 575 S 70th St Ste 310, Lincoln, NE 68510 2016-04-14
1790163814 Mary Elizabeth Tucker Physician Assistant 1500 S 48th St., Suite 800, Lincoln, NE 68506-1200 2015-05-08
1942542790 Linda Denise Corr Physician Assistant 4451 N 26th St Ste 1000, Lincoln, NE 68521-4144 2013-03-20
1669734794 Kimberly Kathryn Piening Physician Assistant 1101 S 70th St Ste 100, Lincoln, NE 68510-4293 2012-06-14
1548521933 Terumi Degraw Physician Assistant 1715 S 26th St, Lincoln, NE 68502-3061 2012-06-02
1609103415 Kristen Alyce Bruening Physician Assistant 8550 Cuthills Cir, Lincoln, NE 68526-9474 2009-11-16
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Competitor

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City LINCOLN
Zip Code 04457

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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