Individual
JAMES BRAD MCCONVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19876 SAINT JOSEPH DR, CENTERVILLE, IA 52544-8850
(641) 856-8684
(641) 856-3009
Mailing address
19876 SAINT JOSEPH DR, CENTERVILLE, IA 52544-8850
(641) 856-8684
(641) 856-3009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19494
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3127381
—
IA
01
—
P00000614
RR MEDICARE
IA
Enumeration date
10/18/2005
Last updated
04/23/2008
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