Individual
CLARENCE JARON BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
132 5TH AVE W STE 1AND2, JEROME, ID 83338-1825
(208) 814-9800
(208) 933-9648
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 962-2313
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
6254
CO
207Q00000X
Family Medicine Physician
Primary
M-13372
ID
208600000X
Surgery Physician
M-13372
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851556229
—
ID
Enumeration date
07/24/2008
Last updated
05/06/2024
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