Julian Debruynkops MD PA

NPI #1932417607 in Idaho Falls, Idaho

Provider Information

NPI Number: 1932417607
Entity Type: Organization
Organization Name: Julian Debruynkops MD PA
Primary Specialty: Family Medicine
Enumeration Date: Sep 16, 2010
Last Updated: Nov 19, 2010

Practice Location

Address: 2065 E 17TH ST
Address 2: SUITE C
City: Idaho Falls
State: Idaho
ZIP Code: 83404-8042
Phone: (208) 522-6106

Authorized Official

Name: DR. JULIAN DE BRUYN KOPS, MD
Title: DIRECTOR
Phone: (208) 522-6106

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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