Healthcare Provider Details

I. General information

NPI: 1417050659
Provider Name (Legal Business Name): JOHN DAVID AUNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 W RUSSELL ST
IRONTON MO
63650-1313
US

IV. Provider business mailing address

PO BOX 85
IRONTON MO
63650-0085
US

V. Phone/Fax

Practice location:
  • Phone: 573-546-3434
  • Fax: 573-546-3006
Mailing address:
  • Phone: 573-546-2292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR5C05
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: