Provider Demographics
NPI:1457434748
Name:ALEXANDER BUNT JR., DO ASSOCIATES
Entity Type:Organization
Organization Name:ALEXANDER BUNT JR., DO ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY CARE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:610-872-2200
Mailing Address - Street 1:422 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-5201
Mailing Address - Country:US
Mailing Address - Phone:610-872-2200
Mailing Address - Fax:610-876-9741
Practice Address - Street 1:422 E 22ND ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5201
Practice Address - Country:US
Practice Address - Phone:610-872-2200
Practice Address - Fax:610-876-9741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-003928L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
080001620OtherPALMETTO
072344Medicare PIN
080001620OtherPALMETTO