Provider Demographics
NPI:1356434070
Name:LUNDY, MCKINLEY SNIPES SR (DO)
Entity type:Individual
Prefix:DR
First Name:MCKINLEY
Middle Name:SNIPES
Last Name:LUNDY
Suffix:SR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 SPRING CREEK ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37412
Mailing Address - Country:US
Mailing Address - Phone:423-553-9675
Mailing Address - Fax:423-553-9677
Practice Address - Street 1:931 SPRING CREEK ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412
Practice Address - Country:US
Practice Address - Phone:423-553-9675
Practice Address - Fax:423-553-9677
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO 5452083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3146041OtherBLUE CROSS/BLUE SHIELD
TN3146041OtherBLUE CROSS/BLUE SHIELD
TN00G707Medicare ID - Type Unspecified