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General NPI Number Information
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NPI Number | 1235108432
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Entity Type | Individual
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Provider Name | GEORGE DAVID MUNDAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 4000 LINWOOD DRIVE SUITE G
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City | PARAGOULD
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State | AR
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Zip | 72450
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Country | US
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Telephone | 870-239-8268
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Fax | 870-239-8277
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Provider Business Mailing Address
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Address Line | 1000 W KINGSHIGHWAY STE 14
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City | PARAGOULD
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State | AR
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Zip | 72450-4197
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Country | US
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Telephone | 870-239-8591
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Fax | 870-239-8137
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 6800A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | E-12405
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License Number State | AR
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