WILLIAM L BUNTAIN

ROCKFORD, IL
NPI1700902608
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2086S0120X Surgery, Pediatric Surgery
(Licence: KS  04-23862)
Additional Taxonomies208600000X Surgery
(Licence: NM  20030056)
208600000X Surgery
(Licence: IL  036131963)
Enumeration Date2007-03-22
Last Update Date2016-11-22
Business Address
WILLIAM L BUNTAIN MD
2350 N ROCKTON AVE
ROCKFORD, IL 61103-3600
Phone number: 815-971-7255
Mailing Address
WILLIAM L BUNTAIN MD
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356