Provider Demographics
NPI:1356637037
Name:DUNFORD, GRETCHEN L (DO)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:L
Last Name:DUNFORD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701-3799
Mailing Address - Country:US
Mailing Address - Phone:785-462-7511
Mailing Address - Fax:785-460-1490
Practice Address - Street 1:100 E COLLEGE DR
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-3799
Practice Address - Country:US
Practice Address - Phone:785-462-7511
Practice Address - Fax:785-460-1490
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101019467208600000X
KS05-38968208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery