William L Buntain, MD
Surgery, Pediatric Surgery in Rockford, IL. Individual provider (NPI-1).
NPI number1700902608
StatusActive
Last updated in NPPESNov 22, 2016
Details
- NPI
- 1700902608
- Entity type
- Individual (NPI-1)
- Name
- William L Buntain
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2007
- Last updated
- Nov 22, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0120X | Surgery, Pediatric Surgery | 04-23862 | KS | Yes |
| 208600000X | Surgery | 20030056 | NM | |
| 208600000X | Surgery | 036131963 | IL |
Practice location
2350 N Rockton AveRockford, IL 61103-3600
Phone 815-971-7255 · Fax 815-971-9955
Mailing address
Po Box 26666Phs Provider Enrollment
Albuquerque, NM 87125-6666
Phone 505-923-5356 · Fax 505-923-5354
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