Dr. JACOB ALEXANDER BRADDOCK D.O.
Individual Provider (NPI-1)
Active
Family Medicine
Provider Information
- NPI Number
1801470984- Provider Type
- Individual Provider (NPI-1)
- Credentials
- D.O.
- Status
- Active
Contact & Location
- Address
- 714 N MICHIGAN ST, SOUTH BEND, IN, 466011035
- Phone
- (574) 647-7477
- Fax
- (574) 647-3655
Specialties & Taxonomies
Family Medicine
Primary License: IN #02007857A
Family Medicine
License: KS #05-51049