Organization
GENE D BRANUM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENE DALE BRANUM MD (OWNER)
(208) 726-3707
Entity
Organization
Contact information
Practice address
180 1ST ST W, STE 301, KETCHUM, ID 83340-0180
(208) 726-3707
(208) 726-4817
Mailing address
PO BOX 3778, KETCHUM, ID 83340-3778
(208) 726-3707
(208) 726-4817
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M-13897
ID
Other
Enumeration date
12/08/2017
Last updated
06/05/2020
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