Provider Demographics
NPI:1962403824
Name:STRUNK, JOHN R (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:R
Last Name:STRUNK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:412 DURANT STREET
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-0246
Mailing Address - Country:US
Mailing Address - Phone:434-447-2898
Mailing Address - Fax:434-447-3456
Practice Address - Street 1:6439 GARNERS FERRY RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1638
Practice Address - Country:US
Practice Address - Phone:803-776-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-034692207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA087971OtherBLUECROSS/BLUESHIELD
VA43144OtherSENTERA/OPTIMA
NC890574KOtherMEDICAID
VA006094309Medicaid
VA290001539OtherR.R. MEDICARE
VA006094309Medicaid
VA290001539OtherR.R. MEDICARE