Provider Demographics
NPI:1659441889
Name:DUNAVANT, WILLIAM DAVID III (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:DAVID
Last Name:DUNAVANT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 381795
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-1795
Mailing Address - Country:US
Mailing Address - Phone:901-767-8301
Mailing Address - Fax:901-767-8302
Practice Address - Street 1:1500 W POPLAR AVE STE 304
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-0601
Practice Address - Country:US
Practice Address - Phone:901-767-8301
Practice Address - Fax:901-767-8302
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNTNMD0000035284208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4014338OtherBLUE CROSS OF TN
TN7750269OtherAETNA
H34528Medicare UPIN
TN3862953Medicare ID - Type Unspecified