Organization
BRUNI PEDIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIM G. BRUNI M.D. (OWNER)
(228) 864-7747
Entity
Organization
Contact information
Practice address
9454 THREE RIVERS RD, SUITE A, GULFPORT, MS 39503-4294
(228) 864-7747
(228) 864-7415
Mailing address
9454 THREE RIVERS RD, SUITE A, GULFPORT, MS 39503-4294
(228) 864-7747
(228) 864-7415
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015616
—
MS
Enumeration date
03/15/2007
Last updated
08/22/2020
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