Provider Demographics
NPI:1558321935
Name:GUNN, RICHARD THOMAS (NP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:THOMAS
Last Name:GUNN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 TEMPLE RD
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-5348
Mailing Address - Country:US
Mailing Address - Phone:508-367-2702
Mailing Address - Fax:
Practice Address - Street 1:1135 MORTON ST
Practice Address - Street 2:
Practice Address - City:MATTAPAN
Practice Address - State:MA
Practice Address - Zip Code:02126-2834
Practice Address - Country:US
Practice Address - Phone:617-533-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA208760363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology