Provider Demographics
NPI:1699160143
Name:JOSEPH W GUNTER III MD PLLC
Entity type:Organization
Organization Name:JOSEPH W GUNTER III MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:GUNTER
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:601-613-1373
Mailing Address - Street 1:304 BELLE POINTE CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7480
Mailing Address - Country:US
Mailing Address - Phone:205-613-1373
Mailing Address - Fax:
Practice Address - Street 1:156 RIVER OAKS DR
Practice Address - Street 2:SUITE B
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-5376
Practice Address - Country:US
Practice Address - Phone:601-605-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-01
Last Update Date:2015-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20808208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty