Individual
ADAM MITCHELL GUNTHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7230 HIGHWAY 45 N STE B, NETTLETON, MS 38858-9399
(662) 963-5050
Mailing address
PO BOX 305, SMITHVILLE, MS 38870-0305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28053
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02137218
—
MS
01
—
1578289
BLUECROSS BLUESHIELD OF MISSISSIPPI
MS
Enumeration date
06/18/2018
Last updated
08/16/2024
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