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NPI Code Detail

MEDICARE: BRADY FLOYD DO

MEDICARE:   BRADY  FLOYD  DO
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
1207R00000XInternal Medicine Physician2025033488MO
2208000000XPediatrics Physician2025033488MO

General Provider Information

NPI Number : 1194304345
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADY FLOYD DO
Provider Business Mailing Address
First Line : 1050 W 10TH ST
Second Line :
City : ROLLA
State : MO
Zip : 65401-2905
Country : US
Telephone Number : 573-364-9000
Fax Number : 573-426-2108
Provider Business Practice Location Address
First Line : 1415 W SCENIC RIVERS BLVD
Second Line :
City : SALEM
State : MO
Zip : 65560-2840
Country : US
Telephone Number : 573-729-5533
Fax Number : 573-202-2466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2021
Last Update Date : 08/19/2025

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