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General NPI Number Information
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NPI Number | 1093714826
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Entity Type | Individual
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Provider Name | JOHN BRUNO ARKUSINSKI D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 206 S CLAY ST STE A
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City | ENNIS
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State | TX
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Zip | 75119-4530
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Country | US
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Telephone | 469-256-2525
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Fax | 469-256-2164
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Provider Business Mailing Address
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Address Line | 206 S CLAY ST STE A
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City | ENNIS
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State | TX
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Zip | 75119-4530
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Country | US
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Telephone | 903-229-4292
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Fax | 903-229-4288
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L3913
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License Number State | TX
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