Individual
MR. GARY A. BRUNVOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7490 ZIEGLER RD, CHATTANOOGA, TN 37421-3156
(423) 648-6020
(423) 648-6025
Mailing address
PO BOX 21709, CHATTANOOGA, TN 37424-0709
(423) 648-6020
(423) 648-6025
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
D0001147
TN
207V00000X
Obstetrics & Gynecology Physician
Primary
DO0000001147
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1531973
—
TN
05
—
3802626
—
TN
Enumeration date
11/29/2006
Last updated
08/14/2015
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