Individual
DR. BRENDA GAIL IZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2638 HIGHWAY 109 STE 101, WILDWOOD, MO 63040-1161
(636) 821-2500
(636) 821-2210
Mailing address
2638 HIGHWAY 109 STE 101, WILDWOOD, MO 63040-1161
(636) 821-2500
(636) 821-2210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R2K89
MO
Other
Enumeration date
09/16/2006
Last updated
11/30/2011
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