Individual
JOHN BRUNNER III
Active
Individual
JOHN BRUNNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C4438
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100073220A
—
OK
05
—
104564001
—
AR
01
—
770119201
ARKANSAS BREASTCARE
AR
Enumeration date
12/01/2005
Last updated
02/10/2012
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