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Individual

MR. JEFFREY WILLIAM BUNNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3185 W STATE ST, SUITE 2010, BRISTOL, TN 37620-1610
(423) 968-7555
(423) 968-7641
Mailing address
3185 W STATE ST, SUITE 2010, BRISTOL, TN 37620-1610
(423) 968-7555
(423) 968-7641

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
38664
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
142951
ANTHEM
VA
01
4087067
BLUE CROSS BLUE SHIELD
TN
01
7957609
AETNA
TN
Enumeration date
08/30/2006
Last updated
07/08/2007
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