Provider Demographics
NPI:1679008502
Name:MULKEY, BRETT (DO)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:MULKEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 4TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-2800
Mailing Address - Country:US
Mailing Address - Phone:641-428-3041
Mailing Address - Fax:
Practice Address - Street 1:1010 4TH ST SW STE 120
Practice Address - Street 2:
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-2856
Practice Address - Country:US
Practice Address - Phone:641-428-6020
Practice Address - Fax:641-428-7803
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05319207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine