Individual
DR. BRIAN ROBERT FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 23RD ST, SPIRIT LAKE, IA 51360-1158
(712) 336-2410
(712) 336-3241
Mailing address
2700 23RD ST, SPIRIT LAKE, IA 51360-1158
(712) 336-2410
(712) 336-3241
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21046
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2177063
—
IA
Enumeration date
01/25/2006
Last updated
12/16/2009
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