Provider Demographics
NPI:1811187420
Name:GUNN, KRISTOPHER HARPER (MD)
Entity type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:HARPER
Last Name:GUNN
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:PO BOX 1028
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47547-1028
Mailing Address - Country:US
Mailing Address - Phone:812-996-5850
Mailing Address - Fax:812-996-5874
Practice Address - Street 1:600 W 13TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-1881
Practice Address - Country:US
Practice Address - Phone:812-996-5850
Practice Address - Fax:812-996-5874
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01071246A208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology