Provider Demographics
NPI:1992755458
Name:BRATTON, JAMES RUFUS JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RUFUS
Last Name:BRATTON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-413-2514
Mailing Address - Fax:843-413-2528
Practice Address - Street 1:800 E CHEVES ST
Practice Address - Street 2:SUITE 370
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2650
Practice Address - Country:US
Practice Address - Phone:843-413-2514
Practice Address - Fax:843-413-2528
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7424207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC074243Medicaid
SC040015019OtherRAILROAD MEDICARE PIN
SCB918086757Medicare PIN
SC074243Medicaid