Robert E Gunnoe, M.D.

Individual provider Active NPI Dermatology Physician · Stanley, KS

NPI 1942297015 · NPPES record last updated Dec 31, 2012

Key facts

NPI
1942297015
Entity type
Individual (NPI type 1)
Primary specialty
Dermatology Physician 207N00000X
License
0417839 (KS)
Practice address
15101 Glenwood Ave
Stanley, KS 66223-3154
Phone
(913) 681-8866
Fax
(913) 338-1311
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0417839KSMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
College Park Family Care Center, P.a. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0417839 KS Yes

Addresses

Primary practice location

15101 Glenwood Ave
Stanley, KS 66223-3154

Mailing address

PO Box 741331
Atlanta, GA 30374-1331
Phone (913) 469-0503

Other providers in Stanley, KS

All providers in Stanley, KS · Dermatology Physician in Kansas

Sources for this page

Verify at the official NPI Registry.