Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack C Bruner III, MD

Individual provider Family Medicine Physician · NPI 1578355806

Jack C Bruner III, MD is a Family Medicine Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2025.

Licensed in
ID
In the registry since
2025
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

777 N Raymond St
Boise, ID 83704-9251
Phone: (208) 514-2500
Fax: (208) 375-2217
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 5071560 (ID)

Record details

NPI number1578355806
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 21, 2025
Last updated in NPPESMay 21, 2025
Certification dateMay 21, 2025
Mailing address777 N Raymond St, Boise, ID 83704-9251

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