Individual
BRUCE S DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
615 OLD SYMSONIA RD, BENTON, KY 42025-5042
(270) 527-4800
Mailing address
PO BOX 755, BENTON, KY 42025-0755
(270) 274-0480
(270) 274-0482
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
876A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74087610
—
KY
Enumeration date
09/29/2006
Last updated
11/30/2016
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