Provider Demographics
NPI:1609846369
Name:GUNN, JOSEPH B (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:GUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-535-7445
Practice Address - Street 1:725 JESSE JEWELL PKWY SE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3834
Practice Address - Country:US
Practice Address - Phone:770-535-3611
Practice Address - Fax:770-535-7092
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021003208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1207112OtherUNITED HEALTHCARE
GA000317402FMedicaid
GA2031829OtherAETNA HMO
GA303671OtherWELLCARE
GA000317402DMedicaid
GA000317402CMedicaid
GA000317402EMedicaid
GA10032967OtherAMERIGROUP
GA303690OtherWELLCARE
GA303691OtherWELLCARE
GA303693OtherWELLCARE
GA52024745OtherBCBS
GA000317402BMedicaid
GA1605016OtherCIGNA
GA4104401OtherAETNA PPO
GA000317402FMedicaid
GA000317402EMedicaid