Provider Demographics
NPI:1518302157
Name:FICKENSCHER, BRADY ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:BRADY
Middle Name:ALLEN
Last Name:FICKENSCHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:983075 NEBRASKA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68198-3075
Mailing Address - Country:US
Mailing Address - Phone:402-559-7249
Mailing Address - Fax:402-559-6501
Practice Address - Street 1:2114 N LINCOLN AVE STE A
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-1072
Practice Address - Country:US
Practice Address - Phone:402-362-5555
Practice Address - Fax:402-559-6501
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-09
Last Update Date:2024-04-29
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Provider Licenses
StateLicense IDTaxonomies
NE6911207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine