Roger S. Brunt M.d. P.a.

NPI #1922287226 in Idaho Falls, Idaho

Provider Information

NPI Number
1922287226
Entity Type
Organization
Organization Name
Roger S. Brunt M.d. P.a.
Primary Specialty
Clinic/Center - Primary Care
Enumeration Date
Nov 2, 2007
Last Updated
Nov 2, 2007

Practice Location

Address
1995 E 17TH ST
State
Idaho
ZIP Code
83404-6493
Phone
(208) 201-3737

Authorized Official

Name
DR. ROGER STEVENSON BRUNT, M.D.
Title
PRESIDENT
Phone
(208) 201-3737

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care

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