Brunda Revanna, MD
NPI #1407943228 in Jacksonville, Alabama
Provider Information
- NPI Number
- 1407943228
- Entity Type
- Organization
- Organization Name
- Brunda Revanna, MD
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Oct 5, 2006
- Last Updated
- Jun 24, 2008
Practice Location
- Address
- 1465 A 1ST AVE SW STE C
- City
- Jacksonville
- State
- Alabama
- ZIP Code
- 36265
- Phone
- (678) 432-4755
Authorized Official
- Name
- DR. BRUNDA REVANNA, M.D.
- Title
- PRESIDENT
- Phone
- (678) 432-4755
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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