Provider Demographics
NPI:1679519235
Name:DENIS, BRUNO OSCAR (MD)
Entity type:Individual
Prefix:DR
First Name:BRUNO
Middle Name:OSCAR
Last Name:DENIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 529
Mailing Address - Street 2:
Mailing Address - City:ROYSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30662-0529
Mailing Address - Country:US
Mailing Address - Phone:706-621-7575
Mailing Address - Fax:706-621-7557
Practice Address - Street 1:1061 DOWDY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5700
Practice Address - Country:US
Practice Address - Phone:706-621-7575
Practice Address - Fax:706-621-7557
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA026502207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine