Brodie, Jonathan J

Brodie, Jonathan J is an individual health care provider with primary practice located at 200 E Tyranena Park Rd , Lake Mills WI 53551-9678. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Brodie, Jonathan J can be contacted via phone (920) 648-3113.

Contact Information

Primary practice address
200 E Tyranena Park Rd Lake Mills WI 53551-9678
Phone: (920) 648-3113
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 30363 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 30363-20 Wisconsin

Profile Details

NPI number 1639134604
LBN Legal business name Brodie, Jonathan J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2006
Last updated Nov 29th, 2013 - about 13 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.

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