MEDICARE: BRUCE KATUNA, MD

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	2084N0400X	Neurology Physician	30103	CO

General Provider Information

NPI Number	:	1124483342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRUCE KATUNA, MD

Provider Business Mailing Address
First Line	:	1511 ONYX CIR
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80504-7805
Country	:	US
Telephone Number	:	303-776-5298
Fax Number	:	303-682-2785

Provider Business Practice Location Address
First Line	:	1511 ONYX CIR
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80504-7805
Country	:	US
Telephone Number	:	303-776-5298
Fax Number	:	303-682-2785

Authorized Official
Title or Position	:	OWNER
Name	:	BRUCE A KATUNA
Credential	:	M.D.
Telephone Number	:	303-776-5298

Provider Enumeration Date	:	12/16/2015
Last Update Date	:	12/16/2015

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