Brodie, Jonathan J
Brodie, Jonathan J is an individual health care provider with primary practice located at 200 E Tyranena Park Rd , Lake Mills WI 53551-9678. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Brodie, Jonathan J can be contacted via phone (920) 648-3113.Contact Information
Primary practice address
200 E Tyranena Park Rd
Lake Mills WI 53551-9678
Phone: (920) 648-3113
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 30363 | Wisconsin |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 30363-20 | Wisconsin |
Profile Details
NPI number | 1639134604 |
---|---|
LBN Legal business name | Brodie, Jonathan J |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 20th, 2006 |
Last updated | Nov 29th, 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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