LARRY R BRUNZLICK


Address: 135 South Gibson Street, Medford, WI 54451
Phone: 7157488100

LARRY R BRUNZLICK (NPI# 1770646721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770646721
Entity Type Individual
Full Name LARRY R BRUNZLICK
Credential MD
Practice Address 135 South Gibson Street
Medford
WI 54451
Practice Telephone 7157488100
Practice Fax Number 7157487590
Mailing Telephone 7157488100
Enumeration Date 2006-12-19
Last Update Date 2012-05-15
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207PE0004X Emergency Medicine
Specialization: Emergency Medical Services
24477 WI Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
WI 30461100 05

Office Location

Street Address 135 SOUTH GIBSON STREET
City MEDFORD
State WI
Zip Code 54451

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558372706 Sammy U Rehman Radiology 135 South Gibson Street, Medford, WI 54451-1622 2006-08-11

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710536321 Bone & Joint Clinic S.c. Durable Medical Equipment & Medical Supplies 724 S. 8th St, Medford, WI 54451 2019-09-06
1215474671 Heidi Marie Nernberger Dental Hygienist 124 S. Main Street, Medford, WI 54451 2017-01-24
1497152656 Rachel E Nichols Dental Hygienist 124 South Main St, Medford, WI 54451 2014-12-03
1811305360 Amanda Mosse Social Worker 10649 W Perkinstown Ave, Medford, WI 54451 2014-07-29
1891081113 Debra Jeanne Zenner Nurse Practitioner 143 South Gibson St., Medford, WI 54451 2011-06-24
1033445036 Greg George Schoofs II Ophthalmology N 4803 Wigwam Ave, Medford, WI 54451 2009-10-26
1558511295 Aspirus Medford Hospital & Clinics, Inc. Clinic/Center 111 S Gibson St, Medford, WI 54451 2008-09-30
1013132430 Aspirus Medford Hospital & Clinics, Inc. Pharmacy 139 S Gibson St, Medford, WI 54451 2007-04-13
1356566707 Peter G Kiefer Pharmacist 139 South Gibson St, Medford, WI 54451 2007-04-13
1851426753 Steven Todd Dietzman Specialist/Technologist 103 South Gibson Street, Medford, WI 54451 2007-02-22
Find all providers in zip 54451

Taxonomy Information

Taxonomy Code 207PE0004X
Grouping Allopathic & Osteopathic Physicians
Classification Emergency Medicine
Specialization Emergency Medical Services

Taxonomy Definition

An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649235219 Victoria V Harris Emergency Medicine 100 E. Main Street, Suite C, Medford, OR 97501-6041 2006-04-18
1700818697 Eric Richard Jensen Emergency Medicine 2825 E. Barnett Rd, Medford, OR 97504-8332 2006-07-07
1366407934 Kenneth R Buccino Emergency Medicine 100 E. Main Street, Suite C, Medford, OR 97501-6041 2006-04-18

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144703653 Quinton Jarrett Peters Emergency Medicine 1204 S Jefferson St, Appleton, WI 54915-1726 2018-09-11
1497792139 John A Culp Emergency Medicine 1446 N Randall Ave, Janesville, WI 53545-1122 2006-06-01
1861440505 Alice C Bustos Emergency Medicine 7220 W National Ave, West Allis, WI 53214-4734 2006-05-05
1184690133 Manuel A. Rivera Emergency Medicine 5000 Memorial Dr, Two Rivers, WI 54241-3900 2006-02-28
1942588132 Watertown Regional Medical Center, Inc Emergency Medicine 125 Hospital Dr, Watertown, WI 53098-3303 2011-07-22
1366692287 James John Macneal Emergency Medicine 1000 Mineral Point Ave, Janesville, WI 53548-2940 2008-09-28
1669563763 Scott A Hathaway Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-27
1639279383 Rajeshwar Hanmiah Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-23
1598863334 George E Vidalakis Emergency Medicine 309 N Bartlett St, Shawano, WI 54166-2127 2006-09-20
1548378367 John Malcolm Mckichan Emergency Medicine 11040 N State Road 77, Hayward, WI 54843-6391 2006-08-29
Find all providers with the same taxonomy

Competitor

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City MEDFORD
Zip Code 54451

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Dataset Information

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.

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