Provider Demographics
NPI:1801210612
Name:RICHARD M JUNKE MD
Entity Type:Organization
Organization Name:RICHARD M JUNKE MD
Other - Org Name:LOCKPORT FAMILY MEDICINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:JUNKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-439-0193
Mailing Address - Street 1:438 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-4742
Mailing Address - Country:US
Mailing Address - Phone:716-439-0193
Mailing Address - Fax:716-438-3543
Practice Address - Street 1:438 HIGH ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-4742
Practice Address - Country:US
Practice Address - Phone:716-439-0193
Practice Address - Fax:716-438-3543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty