Provider Demographics
NPI:1184859662
Name:BRUNSON, RALPH T (DCH)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:T
Last Name:BRUNSON
Suffix:
Gender:M
Credentials:DCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36202-0367
Mailing Address - Country:US
Mailing Address - Phone:256-237-8049
Mailing Address - Fax:256-237-2037
Practice Address - Street 1:600 LEIGHTON AVE STE C
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-5744
Practice Address - Country:US
Practice Address - Phone:256-237-8049
Practice Address - Fax:256-237-2036
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist