Organization
W. LEE BRUNER MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WARNER LEE BRUNER III MD (PRESIDENT)
(225) 921-6801
Entity
Organization
Contact information
Practice address
8068 GOODWOOD BLVD, BATON ROUGE, LA 70806-7631
(225) 921-6801
Mailing address
8068 GOODWOOD BLVD, BATON ROUGE, LA 70806-7631
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014051
MEDICAL LICENSE
LA
05
—
1359335
—
LA
Enumeration date
11/03/2015
Last updated
11/03/2015
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