Individual
DR. ROBERT WAYNE DUNAVANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
610 NUCKOLLS RD, BOLIVAR, TN 38008-1532
(731) 658-7111
(731) 658-4328
Mailing address
610 NUCKOLLS RD, BOLIVAR, TN 38008-1532
(731) 658-7111
(731) 658-4328
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD8754
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080168230
MEDICARE RAILROAD
TN
01
—
3141919
BLUE CROSS BLUE SHIELD
TN
05
—
3173148
—
TN
Enumeration date
02/26/2007
Last updated
02/28/2011
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