Individual
MR. JOHNNY EDWARD BRIAN JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2498
(563) 421-1000
(563) 421-7889
Mailing address
PO BOX 2441, DAVENPORT, IA 52809-2441
(563) 324-8160
(563) 324-8486
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
29071
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093203
—
IA
Enumeration date
12/19/2005
Last updated
07/08/2007
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