Provider Demographics
NPI:1538704945
Name:WAYPOINT MEDICAL LLC
Entity Type:Organization
Organization Name:WAYPOINT MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:515-205-6043
Mailing Address - Street 1:1801 US HIGHWAY 18 E
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428-2162
Mailing Address - Country:US
Mailing Address - Phone:641-357-1999
Mailing Address - Fax:
Practice Address - Street 1:1801 US HIGHWAY 18 E
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-2162
Practice Address - Country:US
Practice Address - Phone:641-357-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty