Brodnax, Jean R
Brodnax, Jean R is an individual health care provider with primary practice located at 111 Grossman Dr Pediatrics Dept, Braintree MA 02184-4997. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Brodnax, Jean R can be contacted via phone (781) 849-2302.Contact Information
Primary practice address
111 Grossman Dr Pediatrics Dept
Braintree MA 02184-4997
Phone: (781) 849-2302
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 49913 | Massachusetts |
Profile Details
| NPI number | 1134117096 |
|---|---|
| LBN Legal business name | Brodnax, Jean R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Jan 7th, 2021 - about 5 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 | 1134117096 | NPPES |
| Massachusetts | MEDICAID | 3191320 |
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