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NPI Code Detail

MEDICARE: MR. ROBERT JAMES BUNN JR.

MEDICARE: MR. ROBERT JAMES BUNN JR.
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
1225800000XRecreation Therapist
2225C00000XRehabilitation Counselor
3376J00000XHomemaker
4106S00000XBehavior Technician
5103K00000XBehavior Analyst
6171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1285335125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT JAMES BUNN JR.
Provider Business Mailing Address
First Line : 4717 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4544
Country : US
Telephone Number : 623-283-4830
Fax Number :
Provider Business Practice Location Address
First Line : 4717 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85008-4544
Country : US
Telephone Number : 623-283-4830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2023
Last Update Date : 03/16/2023

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