Individual
WILLIAM G RUNYON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
69804 SQUIRE LOOP, COVE, OR 97824-8235
(541) 805-0502
Mailing address
PO BOX 2801, LA GRANDE, OR 97850-7801
(541) 805-0502
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44393
TN
Other
Enumeration date
03/26/2012
Last updated
03/07/2017
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