Country Doctor Pc

LBN: Country Doctor Pc
Country Doctor Pc is an health care organization with primary practice located at 18754 Us Highway 63 , Bloomfield IA 52537-6803. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty. Country Doctor Pc can be contacted via phone (641) 664-1799, or through Brodale, Sean D via phone (641) 664-1799.

Contact Information

Primary practice address
18754 Us Highway 63 Bloomfield IA 52537-6803
Phone: (641) 664-1799
Fax: (641) 664-1663
Website:
Map and Directions
Authorized official contact:
Name: Brodale, Sean D Doctor of Osteopathy (DO)
Phone: (641) 664-1799

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X 3485 Iowa
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 3485 Iowa

Profile Details

NPI number 1326078130
LBN Legal business name Country Doctor Pc
DBA Doing business as
Authorized official Brodale, Sean D Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 4th, 2006
Last updated May 21st, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326078130 NPPES
Missouri MEDICAID 209029206
Missouri MEDICAID 2424325

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