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General NPI Number Information
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NPI Number | 1174561476
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Entity Type | Individual
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Provider Name | BRYON JON SCHAEFFER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 220 ESSIE DAVISON DR
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City | CLARINDA
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State | IA
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Zip | 51632-2915
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Country | US
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Telephone | 712-542-8330
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Fax | 712-542-8397
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Provider Business Mailing Address
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Address Line | PO BOX 217
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City | CLARINDA
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State | IA
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Zip | 51632-0217
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Country | US
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Telephone | 712-542-8330
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Fax | 712-542-8397
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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 | 30681
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License Number State | IA
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