Provider Demographics
NPI:1508935776
Name:CHUNN, STANLEY ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:ALLEN
Last Name:CHUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HWY 52 BYPASS WEST
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:615-666-8400
Practice Address - Street 1:200 HWY 52 BYPASS WEST
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:615-666-8400
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16270207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN003132202OtherBLUE CROSS OF TN
110017020OtherMCR RAILROAD
TN3013689Medicaid
TN3013689Medicare ID - Type Unspecified
TN003132202OtherBLUE CROSS OF TN