Provider Demographics
NPI:1558335737
Name:GUNTER, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:GUNTER
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:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77402-0128
Mailing Address - Country:US
Mailing Address - Phone:281-833-3330
Mailing Address - Fax:281-833-3323
Practice Address - Street 1:8427 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-9619
Practice Address - Country:US
Practice Address - Phone:423-499-2712
Practice Address - Fax:281-833-3323
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000017160207RC0200X
TN17160207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00424963OtherRR MEDICARE
3059915OtherINDIVIDUAL MEDICARE PTAN
TN3059915Medicaid
TN4136248OtherBLUE CROSS BLUE SHIELD
TN3059915Medicare PIN
TNP00424963OtherRR MEDICARE