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General NPI Number Information
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NPI Number | 1215981691
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Entity Type | Individual
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Provider Name | WILLIAM N BRODINE MD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 04/01/2015
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Provider Practice Location Address
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Address Line | 3200 NE RALPH POWELL RD
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City | LEES SUMMIT
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State | MO
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Zip | 64064-2301
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Country | US
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Telephone | 816-525-1600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 872332
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City | KANSAS CITY
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State | MO
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Zip | 64187-2332
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Country | US
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Telephone | 816-525-1600
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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 | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | R3E15
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 0419969
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License Number State | KS
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