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General NPI Number Information
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NPI Number | 1144897406
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Entity Type | Individual
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Provider Name | ELLIOTT D BRADY MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 10730 NALL AVE STE 200
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1285
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Country | US
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Telephone | 913-588-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 555 N DUKE ST
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City | LANCASTER
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State | PA
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Zip | 17602-2250
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-51261
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 04-51261
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License Number State | KS
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