MEDICARE: JAMES L BRUTON 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	207RN0300X	Nephrology Physician	C6798	AR
2	207RN0300X	Nephrology Physician	21543	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245228055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES L BRUTON MD

Provider Business Mailing Address
First Line	:	PO BOX 11449
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4005
Country	:	US
Telephone Number	:	479-709-1924
Fax Number	:	479-709-7499

Provider Business Practice Location Address
First Line	:	1500 DODSON AVE
Second Line	:	STE 280
City	:	FORT SMITH
State	:	AR
Zip	:	72901-5182
Country	:	US
Telephone Number	:	479-709-7480
Fax Number	:	479-709-7479

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	11/23/2016

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Directions to “ JAMES L BRUTON MD” Practice Location

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