Bruner, Phillip Mark

Bruner, Phillip Mark is an individual health care provider with primary practice located at 418 E Polk St , Washington IA 52353-1237. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Bruner, Phillip Mark can be contacted via phone (319) 653-2229.

Contact Information

Primary practice address
418 E Polk St Washington IA 52353-1237
Phone: (319) 653-2229
Fax: (319) 653-5040
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME62537 Florida
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X MD-42240 Iowa

Profile Details

NPI number 1114902590
LBN Legal business name Bruner, Phillip Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Feb 4th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114902590 NPPES
Florida Other 198234 HEALTHEASE
Florida Other 208117 HEALTHEASE
Florida Other 00162435 HEALTHEASE
Florida Other 3456144 HEALTHEASE
Florida MEDICAID 370763600 HEALTHEASE
Florida Other 17750 HEALTHEASE

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