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General NPI Number Information
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NPI Number | 1245228055
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Entity Type | Individual
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Provider Name | JAMES L BRUTON MD
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Gender | Male
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 1500 DODSON AVE STE 280
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City | FORT SMITH
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State | AR
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Zip | 72901-5182
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Country | US
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Telephone | 479-709-7480
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Fax | 479-709-7479
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Provider Business Mailing Address
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Address Line | PO BOX 11449
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City | BELFAST
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State | ME
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Zip | 04915-4005
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Country | US
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Telephone | 479-709-1924
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Fax | 479-709-7499
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | C6798
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 21543
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License Number State | OK
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