Healthcare Provider Details

I. General information

NPI: 1093116287
Provider Name (Legal Business Name): STANLEY A CHUNN MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIGHWAY 52 BYP W
LAFAYETTE TN
37083-1727
US

IV. Provider business mailing address

200 HIGHWAY 52 BYP W
LAFAYETTE TN
37083-1727
US

V. Phone/Fax

Practice location:
  • Phone: 615-666-5600
  • Fax:
Mailing address:
  • Phone: 615-666-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STANLEY A CHUNN
Title or Position: MD
Credential:
Phone: 615-666-5164