Provider Demographics
NPI:1902845753
Name:SUNNY, JOSEPH KADATHALAKUNNEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:KADATHALAKUNNEL
Last Name:SUNNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SUNNY
Other - Middle Name:JOSEPH
Other - Last Name:KADATHALAKUNNEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1343 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-1601
Mailing Address - Country:US
Mailing Address - Phone:573-339-7138
Mailing Address - Fax:
Practice Address - Street 1:VETERANS AFFAIRS COMMUNITY CLINIC
Practice Address - Street 2:2420 VETERANS MEMORIAL DR
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701
Practice Address - Country:US
Practice Address - Phone:573-339-0909
Practice Address - Fax:573-339-5940
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry