Provider Demographics
NPI:1043806698
Name:DUNN, JAMES LOWELL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LOWELL
Last Name:DUNN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-3493
Mailing Address - Country:US
Mailing Address - Phone:765-825-7664
Mailing Address - Fax:765-825-7868
Practice Address - Street 1:4200 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-3493
Practice Address - Country:US
Practice Address - Phone:765-825-7664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-17
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013082A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist