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1740270206

NPI Code Detail

MEDICARE: JAMES W BRODSKY MD

MEDICARE: JAMES W BRODSKY MD

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
1	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	F3778	TX
2	207X00000X	Orthopaedic Surgery Physician	F3778	TX
3	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	F3778	TX
4	207XX0801X	Orthopaedic Trauma Physician	F3778	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	840761	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740270206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES W BRODSKY MD

Provider Business Mailing Address
First Line	:	3900 JUNIUS ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-1615
Country	:	US
Telephone Number	:	214-823-7090
Fax Number	:	214-823-1644

Provider Business Practice Location Address
First Line	:	3900 JUNIUS ST
Second Line	:	SUITE 500
City	:	DALLAS
State	:	TX
Zip	:	75246-1615
Country	:	US
Telephone Number	:	214-823-7090
Fax Number	:	214-823-1644

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	09/28/2012

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Directions to “ JAMES W BRODSKY MD” Practice Location

Language	Start Address	Practice Location

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