Provider Demographics
NPI:1366694135
Name:BRUNWORTH, JOSEPH DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DAVID
Last Name:BRUNWORTH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1008 S SPRING AVE # 3300
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-977-8884
Mailing Address - Fax:314-977-1820
Practice Address - Street 1:1225 S. GRAND
Practice Address - Street 2:DOOR 3
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-6310
Practice Address - Country:US
Practice Address - Phone:314-977-5110
Practice Address - Fax:314-977-7686
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2021-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2014035370207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology