Provider Demographics
NPI:1205817004
Name:BUNKERS, PAUL JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:BUNKERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 W 39TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-5700
Mailing Address - Country:US
Mailing Address - Phone:605-335-7744
Mailing Address - Fax:605-373-0343
Practice Address - Street 1:229 W 39TH ST STE 300
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-5700
Practice Address - Country:US
Practice Address - Phone:605-335-7744
Practice Address - Fax:605-373-0343
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD810111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDU46401Medicare UPIN
SDS3582Medicare PIN