| Dr Robert Wayne Dunavant, MD | |
|
610 Nuckolls Rd, Bolivar, TN 38008-1532 | |
| (731) 658-7111 | |
| (731) 658-4328 |
| Full Name | Dr Robert Wayne Dunavant |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 610 Nuckolls Rd, Bolivar, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134255078 | NPI | - | NPPES |
| 3173148 | Medicaid | TN | |
| 080168230 | Other | TN | MEDICARE RAILROAD |
| 3141919 | Other | TN | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD8754 (Tennessee) | Primary |
| Entity Name | Christian Family Medicine, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043252620 PECOS PAC ID: 7315903978 Enrollment ID: O20041206000331 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Robert Wayne Dunavant, MD 610 Nuckolls Rd, Bolivar, TN 38008-1532 Ph: (731) 658-7111 | Dr Robert Wayne Dunavant, MD 610 Nuckolls Rd, Bolivar, TN 38008-1532 Ph: (731) 658-7111 |
Judith Anne Tessema, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 | |
Dr. John Lee Blankenship, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Dr. Samuel Terry Johnson Jr., M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Lawrence Diaz, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Olufemi E Soyinka, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 629 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-3388 Fax: 731-658-4079 | |
Dr. Nithyananda Pakkala, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 630 Nuckolls Rd, Bolivar, TN 38008 Phone: 731-658-6011 Fax: 731-658-9884 |