Individual
DR. BRENT BINKLEY LIEBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5731 GREENDALE RD, SUITE 100, JOHNSTON, IA 50131-1593
(515) 270-1000
(515) 331-6581
Mailing address
5731 GREENDALE RD, SUITE 100, JOHNSTON, IA 50131-1593
(515) 270-1000
(515) 331-6581
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
25797
IA
207Q00000X
Family Medicine Physician
Primary
25797
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720078421
BLUE SHIELD
IA
05
—
1720078421
—
IA
Enumeration date
10/24/2005
Last updated
08/19/2009
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