DR. BENNETT HOWARD BRUCKNER (NPI# 1639270622) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639270622 |
| Entity Type | Individual |
| Full Name | DR. BENNETT HOWARD BRUCKNER |
| Credential | M.D. |
| Practice Address |
11 Doctors Park Dr Ste 240 Spartanburg SC 29307-1008 |
| Mailing Address |
Po Box 743070 Atlanta GA 30374-3070 |
| Practice Telephone | 8643424115 |
| Practice Fax Number | 8643424064 |
| Mailing Telephone | 8645604304 |
| Mailing Fax Number | 8645604413 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-05-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
36622 | SC | Allopathic & Osteopathic Physicians |
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
034547 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 366222 | 05 | |
| GA | 00473228A | 05 | |
| SC | MEDICARE PIN | SC34105206 | 01 |
| Street Address |
11 DOCTORS PARK DR STE 240 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29307-1008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407325509 | Spartanburg Medical Center | Internal Medicine | 11 Doctors Park Dr Ste 240, Spartanburg, SC 29307-1008 | 2018-11-19 |
| 1417443805 | Janine Wright Bullman | Nurse Practitioner | 11 Doctors Park Dr Ste 240, Spartanburg, SC 29307-1008 | 2018-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023677945 | Healogics Specialty Physicians of South Carolina, LLC | Clinic/Center | 1630 Skylyn Drive, Suite 420, Spartanburg, SC 29307 | 2019-06-13 |
| 1194247528 | Tawnia Lee Prince | Occupational Therapy Assistant | 110 Summit Knoll Drive, Spartanburg, SC 29307 | 2017-07-07 |
| 1730633553 | Laura K Taylor | Chiropractor | 1802 Drayton Road, Suite 309, Spartanburg, SC 29307 | 2016-08-10 |
| 1013372390 | Erin Lavette Farr | Nurse Practitioner | 2780 East Main Street, Ltc Health Solutions, Spartanburg, SC 29307 | 2015-12-30 |
| 1316312010 | Joy Rogers | Speech-Language Pathologist | 175 Burdette St, Spartanburg, SC 29307 | 2015-12-07 |
| 1376923169 | Olivia Conrad | Speech-Language Pathologist | 220 Sloans Grove Rd, Spartanburg, SC 29307 | 2015-06-05 |
| 1457755118 | Optimal Radiology Partners of Virginia, Pllc | Radiology | 75 Skylyn Drive, Spartanburg, SC 29307 | 2014-10-09 |
| 1295033272 | Sean Quinn | Pharmacist | 790 East Main Street, Spartanburg, SC 29307 | 2011-03-01 |
| 1417250887 | James Edward Bradof | Internal Medicine | 212 Cypress Creek Drive, Spartanburg, SC 29307 | 2010-12-07 |
| 1528388030 | Tanya Tocharoen Tang | Internal Medicine | 126 Dillon Dr., Spartanburg, SC 29307 | 2010-06-07 |
| Find all providers in zip 29307 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083909402 | Andrew Jonathan Motlis | Internal Medicine | 853 N Church St Ste 620, Spartanburg, SC 29303-3070 | 2011-06-14 |
| 1407809296 | Albert George Fedalei | Internal Medicine | 11 Doctors Park Drive, Suite 240, Spartanburg, SC 29307-1008 | 2006-05-19 |
| 1407325509 | Spartanburg Medical Center | Internal Medicine | 11 Doctors Park Dr Ste 240, Spartanburg, SC 29307-1008 | 2018-11-19 |
| 1568607190 | Mary Black Physicians Group, LLC | Internal Medicine | 11 Doctors Park Dr, Suite 240, Spartanburg, SC 29307-1024 | 2008-12-11 |
| 1760423503 | Spartanburg Medical Center | Internal Medicine | 853 North Church Street, Suite 620, Spartanburg, SC 29303-3040 | 2006-06-10 |
| 1447222690 | Peter J Kobes | Internal Medicine | 853 N Church St, Ste 620, Spartanburg, SC 29303-3040 | 2006-02-02 |
| 1962473777 | Walter James Douglass | Internal Medicine | 853 N Church St, Suite 620, Spartanburg, SC 29303-3098 | 2006-01-30 |
| 1730150723 | Albert Jurdan Mossburg | Internal Medicine | 853 N Church St, Suite 620, Spartanburg, SC 29303-3098 | 2006-01-30 |
| 1861463671 | Mitchell Hurst Allen | Internal Medicine | 853 N Church St, Suite 620, Spartanburg, SC 29303-3098 | 2006-01-30 |
| 1326019316 | Thomas Marcel Montagne | Internal Medicine | 853 N Church St, Suite 620, Spartanburg, SC 29303-3098 | 2006-01-30 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29307 |
Please comment or provide details below to improve the information on DR. BENNETT HOWARD BRUCKNER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.