Individual
DR. KELLY D BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1945 HIGHLAND PIKE, SUITE 1, FT WRIGHT, KY 41017-8127
(859) 331-4005
(859) 331-4606
Mailing address
1945 HIGHLAND PIKE, SUITE 1, FT WRIGHT, KY 41017-8127
(859) 331-4005
(859) 331-4606
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35102
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64069578
—
KY
Enumeration date
01/10/2006
Last updated
01/20/2020
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