Individual
JACK R CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 MOBILE INFIRMARY CIR, MOBILE, AL 36607-3513
(251) 544-1926
(251) 460-2846
Mailing address
PO BOX 9369, MOBILE, AL 36691-0369
(251) 544-1926
(251) 460-2846
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11495
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000017031
—
AL
05
—
009935328
—
AL
05
—
104547
—
AL
Enumeration date
11/10/2005
Last updated
09/07/2010
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