| Dr John Joseph Broderick-cantwell, MD | |
|
7101 Us Highway 90 Ste 103, Daphne, AL 36526-9510 | |
| (251) 517-5800 | |
| (256) 429-9411 |
| Full Name | Dr John Joseph Broderick-cantwell |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 7101 Us Highway 90 Ste 103, Daphne, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760493365 | NPI | - | NPPES |
| 28903 | Other | SC | MEDICAL LICENSE |
| Q48343 | Medicaid | SC | |
| 1353044 | Medicaid | CO | |
| DR-35304 | Other | CO | MEDICAL LICENSE |
| 28950 | Other | AL | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 28950 (Alabama) | Secondary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 28950 (Alabama) | Primary |
| Entity Name | Integrated Behavioral Health Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730522699 PECOS PAC ID: 7416194113 Enrollment ID: O20131007001029 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John Joseph Broderick-cantwell, MD 600 Sun Temple Dr, Madison, AL 35758-8643 Ph: (256) 975-4291 | Dr John Joseph Broderick-cantwell, MD 7101 Us Highway 90 Ste 103, Daphne, AL 36526-9510 Ph: (251) 517-5800 |
Marilyn E Barefoot, RN Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1203 Us Hwy 98, Suite 2a, Daphne, AL 36526 Phone: 251-621-9167 Fax: 251-621-9003 | |
Kathryn Ney, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1026 Stanton Rd, Suite A, Daphne, AL 36526 Phone: 251-626-1182 Fax: 251-217-2085 | |
Dr. Rassan M Tarabein, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 27535 Us Highway 98, Daphne, AL 36526 Phone: 251-625-0909 Fax: 251-380-7390 | |
Georgia A Cutts, RN, C Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1203 Us Hwy 98, Suite 2a, Daphne, AL 36526 Phone: 251-621-9167 Fax: 251-621-9003 | |
Dr. Maridith Hollis, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 7400 Roper Ln, Daphne, AL 36526 Phone: 251-378-6500 Fax: 251-378-6563 | |
Dr. Juan Gerardo Martinez, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 7400 Roper Ln, Daphne, AL 36526 Phone: 251-378-6500 |