Provider Demographics
NPI:1104860592
Name:BRINDLE, CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:BRINDLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 FIRST STREET SE
Mailing Address - Street 2:
Mailing Address - City:BELMOND
Mailing Address - State:IA
Mailing Address - Zip Code:50421-1201
Mailing Address - Country:US
Mailing Address - Phone:641-444-3223
Mailing Address - Fax:641-444-4896
Practice Address - Street 1:403 FIRST STREET SE
Practice Address - Street 2:
Practice Address - City:BELMOND
Practice Address - State:IA
Practice Address - Zip Code:50421-1201
Practice Address - Country:US
Practice Address - Phone:641-444-3223
Practice Address - Fax:641-444-4896
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23027207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA66046OtherBCBS SNF
IA0424507Medicaid
IA33444OtherFPC BCBS NRH
IA60046OtherBCBS REG
IA0600460Medicaid
IA0635011Medicaid
IA29352OtherBCBS ER
IA0293522Medicaid
IA3214114Medicaid
IA0283465Medicaid
IA0655001Medicaid
IA36174OtherBCBS DME
IACE8231Medicare Oscar/Certification
IA66046OtherBCBS SNF
IA0655001Medicaid
IA36174OtherBCBS DME
IA163495Medicare ID - Type UnspecifiedFPC MEDICARE
IA161302Medicare Oscar/Certification
IA0381980001Medicare NSC
IA29352Medicare ID - Type UnspecifiedHOSPITAL MEDICARE PART B