Provider Demographics
NPI:1750812285
Name:BUNTEN, ELIZABETH JOY (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JOY
Last Name:BUNTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:JOY
Other - Last Name:BILLQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:718 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:MO
Mailing Address - Zip Code:63461-1923
Mailing Address - Country:US
Mailing Address - Phone:630-414-7050
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2001
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4408
Practice Address - Fax:513-636-7337
Is Sole Proprietor?:No
Enumeration Date:2017-03-26
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.146573207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program