Provider Demographics
NPI:1134497019
Name:DUNHAM, JAMES A
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:DUNHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:A
Other - Last Name:DUNHAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:1414 3RD ST NW
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1928
Mailing Address - Country:US
Mailing Address - Phone:406-761-8420
Mailing Address - Fax:
Practice Address - Street 1:1414 3RD ST NW
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1928
Practice Address - Country:US
Practice Address - Phone:406-761-8420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5022183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist