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NPI Code Detail

MEDICARE: MR. ROBERT HARRY BROCKMAN DC

MEDICARE:  MR. ROBERT HARRY BROCKMAN  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor04987IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
210206OTHERIABCBS

General Provider Information

NPI Number : 1053312967
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT HARRY BROCKMAN DC
Provider Business Mailing Address
First Line : PO BOX 352
Second Line :
City : FORT MADISON
State : IA
Zip : 52627-0352
Country : US
Telephone Number : 319-372-3800
Fax Number :
Provider Business Practice Location Address
First Line : 2311 AVENUE L STE 3
Second Line :
City : FORT MADISON
State : IA
Zip : 52627-4031
Country : US
Telephone Number : 319-372-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2005
Last Update Date : 01/21/2010

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Directions to “ MR. ROBERT HARRY BROCKMAN DC” Practice Location

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