Healthcare Provider Details

I. General information

NPI: 1467431494
Provider Name (Legal Business Name): JOANNE LOUISE BUJNOSKI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 04/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4724 N DAVIS HWY
PENSACOLA FL
32503-2339
US

IV. Provider business mailing address

4724 N DAVIS HWY
PENSACOLA FL
32503-2339
US

V. Phone/Fax

Practice location:
  • Phone: 850-696-4000
  • Fax: 850-607-7317
Mailing address:
  • Phone: 850-696-4000
  • Fax: 850-607-7317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberDO316
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number0S 4944
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: