| Dr John Scott Broderick, MD | |
|
13133 N Port Washington Rd, Suite G06, Mequon, WI 53097-2419 | |
| (262) 243-8371 | |
| (262) 243-8342 |
| Full Name | Dr John Scott Broderick |
|---|---|
| Gender | Male |
| Speciality | Neurology |
| Experience | 23 Years |
| Location | 13133 N Port Washington Rd, Mequon, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508939976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | 46762-020 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension Columbia St Mary's Hospital Milwaukee | Milwaukee, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Columbia St Marys Hospital Milwaukee Inc | 5890604722 | 299 |
| Entity Name | Columbia St Marys Hospital Milwaukee Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John Scott Broderick, MD 4425 N Port Washington Rd, Attn: Csmcp Clnic Credentialing, Glendale, WI 53212-1082 Ph: (262) 243-8371 | Dr John Scott Broderick, MD 13133 N Port Washington Rd, Suite G06, Mequon, WI 53097-2419 Ph: (262) 243-8371 |
Dr. Laurens D. Young, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 11514 N Port Washington Rd, Suite 4, Mequon, WI 53092 Phone: 262-241-7025 | |
Dr. Wess R Vogt, M.D. Psychiatry & Neurology Medicare: May Accept Medicare Assignments Practice Location: 1035 W Glen Oaks Ln, Suite 204, Mequon, WI 53092 Phone: 262-512-9400 | |
Dr. Donna J Brehm, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1035 W Glen Oaks Ln, Suite 204, Mequon, WI 53092 Phone: 262-512-9400 | |
Dr. Jeffrey E Taxman, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 11501 N Port Washington Rd, G30, Mequon, WI 53092 Phone: 262-241-8100 Fax: 262-241-8200 | |
Guy R Lord, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1035 W Glen Oaks Ln, Suite 204, Mequon, WI 53092 Phone: 262-512-9400 | |
Julia Hinkle Penn, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1045 W Glen Oaks Ln, Suite 1, Mequon, WI 53092 Phone: 262-241-4664 Fax: 262-241-1012 | |
Dr. Caroline Nicole Palmer, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 1009 W Glen Oaks Ln, Suite 110, Mequon, WI 53092 Phone: 262-222-2446 Fax: 262-228-8052 |