Healthcare Provider Details

I. General information

NPI: 1780251991
Provider Name (Legal Business Name): BRYAN RICHARDS BOZUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E MARKET ST
IOWA CITY IA
52245-2633
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-339-3551
  • Fax: 319-248-7945
Mailing address:
  • Phone: 319-356-3375
  • Fax: 319-353-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberMD-56926
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD-56926
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: