Dunavant, Robert Wayne

Dunavant, Robert Wayne is an sole proprietor health care provider with primary practice located at 610 Nuckolls Rd , Bolivar TN 38008-1532. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dunavant, Robert Wayne can be contacted via phone (731) 658-7111.

Contact Information

Primary practice address
610 Nuckolls Rd Bolivar TN 38008-1532
Phone: (731) 658-7111
Fax: (731) 658-4328
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD8754 Tennessee

Profile Details

NPI number 1134255078
LBN Legal business name Dunavant, Robert Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 26th, 2007
Last updated Feb 28th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134255078 NPPES
Tennessee MEDICAID 3173148
Tennessee Other 080168230
Tennessee Other 3141919

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