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General NPI Number Information
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NPI Number | 1205812948
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Entity Type | Individual
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Provider Name | RICHARD BURNS CUNNINGHAM JR. MD
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Gender | Male
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 353 BOGLE ST
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City | SOMERSET
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State | KY
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Zip | 42503
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Country | US
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Telephone | 606-678-2220
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Fax | 606-451-0595
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Provider Business Mailing Address
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Address Line | PO BOX 32569
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City | KNOXVILLE
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State | TN
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Zip | 37930-2569
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Country | US
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Telephone | 865-694-0062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 34264
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 34264
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License Number State | KY
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