Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | 40730 | TN |
Y | 2086S0127X | Trauma Surgeon | 40730 | TN |
NPI | 1235167388 |
---|---|
Provider Name | Oliver L Gunter JR. |
First Address | Nashville, TN 37212-2717 |
Second Address | Nashville, TN 37232-0004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
204596902 | (05) | MO |
I56010 | (02) |