Provider Demographics
NPI:1902838527
Name:BUNKER, ORVILLE W III (MD)
Entity Type:Individual
Prefix:DR
First Name:ORVILLE
Middle Name:W
Last Name:BUNKER
Suffix:III
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 1:300 N 4TH AVE E
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3155
Mailing Address - Country:US
Mailing Address - Phone:641-792-2112
Mailing Address - Fax:641-792-8484
Practice Address - Street 1:300 N 4TH AVE E
Practice Address - Street 2:SUITE 200
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3155
Practice Address - Country:US
Practice Address - Phone:641-792-2112
Practice Address - Fax:641-792-8484
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAFO3378Medicare UPIN
IA10656Medicare ID - Type Unspecified
IA0094706Medicare ID - Type Unspecified