Organization · Type 2 NPI
Brunda Revanna, MD
Primary Care Clinic/Center · Jacksonville, AL
NPI number
1407943228
Active
Practice location
1465 A 1st Ave SW Ste C
Jacksonville, AL 36265
Mailing address
950 Eagles Landing Pkwy #321
Stockbridge, GA 30281
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | None listed |
Primary Care Clinic/Center: Definition to come...
Other primary care clinic/center providers in Jacksonville
About NPI 1407943228
Brunda Revanna, MD's National Provider Identifier is 1407943228, issued on Oct 5, 2006. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Jacksonville, AL. The record was last updated on Jun 24, 2008.