MEDICARE: DR. WILLIAM THOMAS GUNNING III PH.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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1225166689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM THOMAS GUNNING III PH.D.

Provider Business Mailing Address
First Line	:	3035 ARLINGTON AVENUE
Second Line	:	UNIVERSITY OF TOLEDO- HEALTH SCIENCE CAMPUS
City	:	TOLEDO
State	:	OH
Zip	:	43614-2598
Country	:	US
Telephone Number	:	419-383-3752
Fax Number	:

Provider Business Practice Location Address
First Line	:	3035 ARLINGTON AVENUE
Second Line	:	DEPT OF PATHOLOGY, UNIVERSITY OF TOLEDO- HSC
City	:	TOLEDO
State	:	OH
Zip	:	43614-2598
Country	:	US
Telephone Number	:	419-383-3752
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2007
Last Update Date	:	07/08/2007

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