Provider Demographics
NPI:1083643506
Name:DUNN, JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:DUNN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4368 E CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-2988
Mailing Address - Country:US
Mailing Address - Phone:479-422-7212
Mailing Address - Fax:479-966-4713
Practice Address - Street 1:4368 E CHURCHILL DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-2988
Practice Address - Country:US
Practice Address - Phone:479-422-7212
Practice Address - Fax:479-966-4713
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-0931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE-0931OtherARKANSAS STATE MEDICAL LICENSE
AR154659003Medicaid
OK3541OtherOKLAHOMA MEDICAL LICENSE
OK3541OtherOKLAHOMA MEDICAL LICENSE
ARG50443Medicare UPIN