| Larry R Brunzlick, MD | |
|
135 South Gibson Street, Medford, WI 54451 | |
| (715) 748-8100 | |
| (715) 748-7590 |
| Full Name | Larry R Brunzlick |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 45 Years |
| Location | 135 South Gibson Street, Medford, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770646721 | NPI | - | NPPES |
| 30461100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 24477 (Wisconsin) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fayette County Hospital | Vandalia, IL | Hospital |
| Franklin Hospital | Benton, IL | Hospital |
| Thomas H Boyd Memorial Hospital | Carrollton, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Integritas Emergency Physician Services Llc | 7113167446 | 28 |
| Thomas H Boyd Memorial Hospital | 8123085560 | 22 |
| Entity Name | Thomas H Boyd Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811096811 PECOS PAC ID: 8123085560 Enrollment ID: O20041216000800 |
| Entity Name | Thomas H Boyd Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1811096811 PECOS PAC ID: 8123085560 Enrollment ID: O20110118000703 |
| Entity Name | Integritas Emergency Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790128817 PECOS PAC ID: 7113167446 Enrollment ID: O20130710000760 |
| Mailing Address | Practice Location Address |
|---|---|
| Larry R Brunzlick, MD 135 South Gibson Street, Medford, WI 54451 Ph: (715) 748-8100 | Larry R Brunzlick, MD 135 South Gibson Street, Medford, WI 54451 Ph: (715) 748-8100 |
Steven Fredrick Hansen, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 135 South Gibson, Medford, WI 54451 Phone: 715-748-8100 Fax: 715-748-7590 | |
Ronald L Kowle, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 143 S Gibson St, Medford, WI 54451 Phone: 715-748-2121 |