Brian, Johnny Edward
Brian, Johnny Edward is an individual health care provider with primary practice located at 1227 E Rusholme St , Davenport IA 52803-2498. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Brian, Johnny Edward can be contacted via phone (563) 421-1000.Contact Information
Primary practice address
1227 E Rusholme St
Davenport IA 52803-2498
Phone: (563) 421-1000
Fax: (563) 421-7889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 29071 | Iowa |
Profile Details
| NPI number | 1174509442 |
|---|---|
| LBN Legal business name | Brian, Johnny Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 19th, 2005 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174509442 | NPPES |
| Iowa | MEDICAID | 1093203 |
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