Individual
JOHN BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1801 US HIGHWAY 18 E, CLEAR LAKE, IA 50428-2162
(641) 357-1999
(641) 357-1997
Mailing address
1801 US HIGHWAY 18 E, CLEAR LAKE, IA 50428-2162
(641) 357-1999
(641) 357-1997
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02940
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080179260
RAILROAD MEDICARE NUMBER
IA
01
—
1154382513
WELLMARK
IA
05
—
1154382513
—
IA
Enumeration date
03/28/2006
Last updated
07/14/2020
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