Provider Demographics
NPI:1245595438
Name:DUNN, JEFFREY HOLTER (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HOLTER
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:559 VINCENT ST
Mailing Address - Street 2:ATTN: 302 ASTS
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-556-1132
Mailing Address - Fax:719-556-1129
Practice Address - Street 1:559 VINCENT ST
Practice Address - Street 2:ATTN: 302 ASTS
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-556-1132
Practice Address - Fax:719-556-1129
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0052790207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology