Individual
JONATHAN J BRODIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9678
(920) 648-3113
Mailing address
200 E TYRANENA PARK RD, LAKE MILLS, WI 53551-9678
(920) 648-3113
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
30363
WI
207Q00000X
Family Medicine Physician
Primary
30363-20
WI
Other
Enumeration date
04/20/2006
Last updated
11/29/2013
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