Brunson, Zachery M

Brunson, Zachery M is an individual health care provider with primary practice located at 393 E 2Nd N , Rexburg ID 83440. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Brunson, Zachery M can be contacted via phone (208) 356-5401.

Contact Information

Primary practice address
393 E 2Nd N Rexburg ID 83440
Fax: (208) 356-3111
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA-607 Idaho

Profile Details

NPI number 1447296785
LBN Legal business name Brunson, Zachery M
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Apr 13th, 2020 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1447296785 NPPES
Idaho MEDICAID 807432900

Popular Providers