Provider Demographics
NPI:1801201348
Name:BUNCE, ALEX (DO)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:BUNCE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E SPRING VALLEY PIKE
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2653
Mailing Address - Country:US
Mailing Address - Phone:937-436-3117
Mailing Address - Fax:937-436-0730
Practice Address - Street 1:220 E SPRING VALLEY PIKE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-2653
Practice Address - Country:US
Practice Address - Phone:937-436-3117
Practice Address - Fax:937-436-0730
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1708207Q00000X
OH34.011935207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0367824Medicaid