Individual
DR. MOLLY MAGGARD BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
115 HUSTON DR STE 1, SHEPHERDSVILLE, KY 40165-7250
(502) 955-7311
(502) 891-8338
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5196
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52490
KY
208000000X
Pediatrics Physician
52490
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52490
MEDICAL LICENSE
KY
05
—
7100430860
—
KY
01
—
K310660
MEDICARE
KY
Enumeration date
03/30/2015
Last updated
02/09/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us