Individual
JEFFREY ALAN BRODSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2131 LAKE AVE, SUITE #1, ASHTABULA, OH 44004-3466
(440) 997-6646
(440) 992-4238
Mailing address
2131 LAKE AVE STE 1, ASHTABULA, OH 44004-3466
(440) 997-6646
(440) 992-4238
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4336
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000136131
ANTHEM
OH
05
—
0678646
—
OH
01
—
110020548
RAILROAD MEDICARE
—
Enumeration date
10/25/2006
Last updated
04/24/2008
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