Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 049851 | GA |
Y | 2081P2900X | Pain Medicine | 53986 | TN |
N | 2081P2900X | Pain Medicine | MD53986 | TN |
NPI | 1316086606 |
---|---|
Provider Name | Timothy R Bunker |
First Address | Knoxville, TN 37909-1903 |
Second Address | Oneida, TN 37841 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 03/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01779038 | AMERIGROUP (01) | GA |
451469306D | (05) | GA |
466485 | WELLCARE (01) | GA |
P01193373 | RR MEDICARE (01) | GA |
Q022991 | (05) | TN |