Individual
HARLAN JASON BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2142 W BROAD ST, BUILDING 100, STE 200, ATHENS, GA 30606-3506
(706) 548-6881
(706) 546-0821
Mailing address
PO BOX 48089, ATHENS, GA 30604-8089
(706) 389-3740
(706) 389-3951
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
234690
NY
207T00000X
Neurological Surgery Physician
Primary
64902
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003106211A
—
GA
Enumeration date
03/24/2008
Last updated
06/20/2019
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