Provider Demographics
NPI:1336335207
Name:WILLIAM E GUNN MD LLC
Entity Type:Organization
Organization Name:WILLIAM E GUNN MD LLC
Other - Org Name:GUNN FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-828-7300
Mailing Address - Street 1:12076B HWY 231 431 N
Mailing Address - Street 2:
Mailing Address - City:MERIDIANVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35759-1225
Mailing Address - Country:US
Mailing Address - Phone:256-828-7300
Mailing Address - Fax:256-828-6394
Practice Address - Street 1:12076B HWY 231 431 N
Practice Address - Street 2:
Practice Address - City:MERIDIANVILLE
Practice Address - State:AL
Practice Address - Zip Code:35759-1225
Practice Address - Country:US
Practice Address - Phone:256-828-7300
Practice Address - Fax:256-828-6394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26979207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K797OtherMEDICARE GROUP
DF5752OtherR R MEDICARE