Provider Demographics
NPI:1700049699
Name:KUNES, JUSTIN RONALD (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:RONALD
Last Name:KUNES
Suffix:
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 1:2450 OLD MILTON PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2521
Mailing Address - Country:US
Mailing Address - Phone:470-267-0190
Mailing Address - Fax:770-999-2612
Practice Address - Street 1:2450 OLD MILTON PKWY STE 204
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2521
Practice Address - Country:US
Practice Address - Phone:470-267-0190
Practice Address - Fax:770-999-2612
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA66201207X00000X, 207XP3100X, 207XS0106X
LA312161207X00000X, 207XP3100X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL336822OtherAVMED
FL7222349OtherCIGNA
FL147QLOtherBC/BS
GA003109930AMedicaid
FL002043800Medicaid
FLDR430Medicare PIN
FL9689368OtherAETNA