Provider Demographics
NPI:1639411366
Name:BRUNS, KYLE LOUIS (DO)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:LOUIS
Last Name:BRUNS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8054
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:800-862-9980
Mailing Address - Fax:314-362-1185
Practice Address - Street 1:3015 N BALLAS RD
Practice Address - Street 2:DEPT ANESTHESIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2329
Practice Address - Country:US
Practice Address - Phone:800-862-9980
Practice Address - Fax:314-362-1185
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2022-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2017014861207L00000X, 207LC0200X
MTMED-PHYS-LIC-112135207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology