Individual
DR. RANDALL JAMES BRENNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 NORTH 1ST STREET RADIATION ONCOLOGY, SPRINGFIELD, IL 62781-1032
(217) 528-7541
(314) 747-9557
Mailing address
4921 PARKVIEW PL, DEPT RADIATION ONCOLOGY, LL, SAINT LOUIS, MO 63110-1032
(314) 747-7236
(314) 747-9557
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036156598
IL
2085R0001X
Radiation Oncology Physician
2021019467
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200061655
—
MO
Enumeration date
05/16/2016
Last updated
08/19/2024
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