Basic Information
| Provider Information | |||||||||
| NPI: | 1922169663 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | O'HARE | ||||||||
| FirstName: | BRADY | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 211 W 33RD ST | ||||||||
| Address2: | |||||||||
| City: | KEARNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 688453484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3088652141 | ||||||||
| FaxNumber: | 3088652151 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 W 33RD ST | ||||||||
| Address2: | |||||||||
| City: | KEARNEY | ||||||||
| State: | NE | ||||||||
| PostalCode: | 688453484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3088652141 | ||||||||
| FaxNumber: | 3088652151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 09/14/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 23481 | OK | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.