MEDICARE: DR. KELLY D BRUNSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35102	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508845314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY D BRUNSON M.D.

Provider Business Mailing Address
First Line	:	1945 HIGHLAND PIKE
Second Line	:	SUITE 1
City	:	FT WRIGHT
State	:	KY
Zip	:	41017-8127
Country	:	US
Telephone Number	:	859-331-4005
Fax Number	:	859-331-4606

Provider Business Practice Location Address
First Line	:	1945 HIGHLAND PIKE
Second Line	:	SUITE 1
City	:	FT WRIGHT
State	:	KY
Zip	:	41017-8127
Country	:	US
Telephone Number	:	859-331-4005
Fax Number	:	859-331-4606

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	01/20/2020

Similar Medicare Providers

1053390799 — DR. DARLA N CAHILL M.D.
Practice Location Address:

1945 HIGHLAND PIKE , SUITE 1
FT WRIGHT, KY
41017-8127

Practice Phone: 859-331-4005
Practice Fax: 859-331-4606

1336209865 — PEDIATRIC PARTNERS OF NORTHERN KENTUCKY
Practice Location Address:

1945 HIGHLAND PIKE , SUITE 1
FT WRIGHT, KY
41017-8127

Practice Phone: 859-331-4005
Practice Fax:

1720371255 — BRIDGET MARIE FRANCE MD
Practice Location Address:

1945 HIGHLAND PIKE , SUITE 1
FT WRIGHT, KY
41017-8127

Practice Phone: 859-331-4005
Practice Fax:

1922441427 — MARY KATHLEEN NELMS APRN
Practice Location Address:

1945 HIGHLAND PIKE , SUITE 1
FT WRIGHT, KY
41017-8127

Practice Phone: 859-331-4005
Practice Fax: 859-331-4606

1801216783 — ALLISON FERREE-CHAVEZ
Practice Location Address:

1945 HIGHLAND PIKE STE 1
FT WRIGHT, KY
41017-8127

Practice Phone: 859-331-4005
Practice Fax: 859-331-4606

1194352575 — PRISCILLA JOY TANG MD
Practice Location Address:

1945 HIGHLAND PIKE STE 1
FT WRIGHT, KY
41017-8127

Practice Phone: 859-331-4005
Practice Fax: 859-331-4606

Directions to “ DR. KELLY D BRUNSON M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.