Provider Demographics
NPI:1093116287
Name:STANLEY A CHUNN MD
Entity Type:Organization
Organization Name:STANLEY A CHUNN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-666-5164
Mailing Address - Street 1:200 HIGHWAY 52 BYP W
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083-1727
Mailing Address - Country:US
Mailing Address - Phone:615-666-5600
Mailing Address - Fax:
Practice Address - Street 1:200 HIGHWAY 52 BYP W
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083-1727
Practice Address - Country:US
Practice Address - Phone:615-666-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3132202OtherBLUE CROSS BLUE SHIELD
TN3013689Medicaid
TNA97771Medicare UPIN
TN3013689Medicaid