Provider Demographics
NPI:1306812714
Name:OVERTON, BRENT A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:A
Last Name:OVERTON
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 1:2751 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-9509
Mailing Address - Country:US
Mailing Address - Phone:319-338-3606
Mailing Address - Fax:319-338-0522
Practice Address - Street 1:2751 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9509
Practice Address - Country:US
Practice Address - Phone:319-338-3606
Practice Address - Fax:319-338-0522
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33874207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA200040154OtherRAILROAD MEDICARE
IA0238188Medicaid
IA25307OtherWELLMARK BCBS OF IA
IAH37368Medicare UPIN
IAI2143Medicare ID - Type UnspecifiedMEDICARE