Provider Demographics
NPI:1952324154
Name:BRUMFIELD, JOHN MORGAN (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MORGAN
Last Name:BRUMFIELD
Suffix:
Gender:M
Credentials:MD
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 3395
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1373 E SR 62
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250
Practice Address - Country:US
Practice Address - Phone:812-801-0156
Practice Address - Fax:812-801-8084
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039452B207L00000X
NE28058207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100375750Medicaid
IN412840068OtherMEDICARE
KY50118519OtherKY PASSPORT
KY7100456470Medicaid
IN1052554OtherANTHEM
IN5479085OtherAETNA