Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD436094 | PA |
Y | 2086S0105X | Surgery of the Hand | MD436094 | PA |
NPI | 1578778676 |
---|---|
Provider Name | Lance M Brunton |
First Address | Jeannette, PA 15644-2538 |
Second Address | N Huntingdon, PA 15642-2718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 13/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023034770 | (05) | PA |