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General NPI Number Information
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NPI Number | 1801210612
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Entity Type | Organization
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Legal Business Name | RICHARD M JUNKE MD
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 438 HIGH ST
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City | LOCKPORT
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State | NY
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Zip | 14094-4742
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Country | US
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Telephone | 716-439-0193
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Fax | 716-438-3543
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Provider Business Mailing Address
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Address Line | 438 HIGH ST
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City | LOCKPORT
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State | NY
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Zip | 14094-4742
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Country | US
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Telephone | 716-439-0193
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Fax | 716-438-3543
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | RICHARD M JUNKE
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Credential | MD
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Telephone | 716-439-0193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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