Thomas E. Bruderly, DO, LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

THOMAS E. BRUDERLY, DO, LLC

Practice address

201 5TH St NE
Suite 3
Barberton, OH 44203-3017

Phone

(330) 848-0123

Fax

(330) 848-1493

NPI assigned

Jan 15, 2008

Last updated

Apr 18, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thomas E Bruderly, DO

Title

Managing Member

Phone

(330) 848-0123

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240012800000",
    "number": "1083890594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 5TH ST NE",
            "address_2": "SUITE 3",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442033017",
            "telephone_number": "330-848-0123",
            "fax_number": "330-848-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 5TH ST NE",
            "address_2": "SUITE 3",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442033017",
            "telephone_number": "330-848-0123",
            "fax_number": "330-848-1493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS E. BRUDERLY, DO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2009-04-18",
        "status": "A",
        "authorized_official_last_name": "BRUDERLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "330-848-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Barberton, OH
• Providers in Barberton, OH by specialty
• Otolaryngology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.