Individual
DR. MARK I. BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
212 S 2ND ST, DANVILLE, KY 40422-1804
(859) 236-5302
(859) 236-5025
Mailing address
4071 TATES CREEK CENTRE DR, STE 202, LEXINGTON, KY 40517-3094
(859) 971-4695
(859) 971-4604
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
40350
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100006290
—
KY
Enumeration date
02/22/2006
Last updated
12/08/2020
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