DR. BRADEN RUSS BRKLACICH DPM NPI 1609397207

NPI Information

DR. Braden Russ Brklacich, DPM is a foot and ankle surgery podiatrist in Riverton, UT with 7 years of experience. DR. Braden Russ Brklacich, DPM NPI is 1609397207. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Graduation Year:2017

The provider's business location address is:

12523 S CREEK MEADOW RD STE 105
RIVERTON, UT
ZIP 84065-299
Phone: (801) 253-6886

The NPI 1609397207 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/5/2017 and was last updated on 2/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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