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Contact Information

BRIAN G BROADHEAD, DPM
111 FLORISSANT OAKS SHOP CTR
FLORISSANT, MO63031-3933
 Phone: 314-837-8477
 Fax: 314-837-0611
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BRIAN G BROADHEAD · (Male)

NPI # 1275573081
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 06/08/2006
Last updated 07/29/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2001014944
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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