Individual
DR. HAROLD JAY BRUNINGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 CAPITAL AIRPORT DR, SPRINGFIELD, IL 62707-8410
(217) 473-7386
(217) 473-7386
Mailing address
2125 SOUTHBROOKE RD, JACKSONVILLE, IL 62650-9201
(217) 243-7274
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036073892
IL
2083A0100X
Aerospace Medicine Physician
Primary
036073892
IL
Other
Enumeration date
03/12/2006
Last updated
01/17/2018
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