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NPI Code Detail

MEDICARE: DR. GEORGE A. CUNNINGHAM O.D.

MEDICARE:  DR. GEORGE A. CUNNINGHAM  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOD476TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013085323
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE A. CUNNINGHAM O.D.
Provider Business Mailing Address
First Line : 140 W MAIN ST
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-1308
Country : US
Telephone Number : 423-727-7241
Fax Number : 423-727-7760
Provider Business Practice Location Address
First Line : 140 W MAIN ST
Second Line :
City : MOUNTAIN CITY
State : TN
Zip : 37683-1308
Country : US
Telephone Number : 423-727-7241
Fax Number : 423-727-7760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 07/08/2007

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Directions to “ DR. GEORGE A. CUNNINGHAM O.D.” Practice Location

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