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DR. GERALD FRANK BUNTING-BLAKE M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1417934662

Individual Registrant:
DR. GERALD FRANK BUNTING-BLAKE M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
5380 E KACHINA ST  DAVIS MONTHAN A F B, AZ 85707-4923 US
Tel: 520-228-4926  Fax: --

Contact information for business:
2125 E GOLF AVE  TEMPE, AZ 85282-4031 US
Tel: 480-201-0781  Fax: --

Registration Information:
NPI: 1417934662
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
AZ31378
N207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
NE13051
Y2084P0800XAllopathic & Osteopathic Physicians
Psychiatry & Neurology
AZ31378
N2084P0800XAllopathic & Osteopathic Physicians
Psychiatry & Neurology
NE13051

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS AZ - Page 1



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