Brady, Jonathan D

Brady, Jonathan D is an individual health care provider with primary practice located at 1235 E Cherokee St , Springfield MO 65804-2203. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Brady, Jonathan D can be contacted via phone (417) 820-2829.

Contact Information

Primary practice address
1235 E Cherokee St Springfield MO 65804-2203
Phone: (417) 820-2829
Fax: (417) 820-8852
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 2012031847 Missouri

Profile Details

NPI number 1215287990
LBN Legal business name Brady, Jonathan D
Credentials Associate of Arts (AA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 11th, 2012
Last updated Feb 22nd, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215287990 NPPES
Missouri Other 431560263 TRICARE
Missouri MEDICAID 1215287990 TRICARE
Missouri Other P01129108 TRICARE

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