Provider Demographics
NPI:1306885447
Name:CUNNINGHAM, LOUIS E (MD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:E
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CENTRE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2862
Mailing Address - Country:US
Mailing Address - Phone:731-512-0104
Mailing Address - Fax:731-668-7388
Practice Address - Street 1:17 CENTRE PLAZA DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-2862
Practice Address - Country:US
Practice Address - Phone:731-512-0104
Practice Address - Fax:731-668-7388
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33426174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN060021316OtherPALMETTO GBA RR MEDICARE
TN0118130OtherBCBS
TN3059829Medicaid
TN115771OtherUNISON
TN7935OtherTLC
TN3059829Medicare ID - Type Unspecified