Provider Demographics
NPI:1437527884
Name:DUNLAP PHYSICIANS LLC
Entity Type:Organization
Organization Name:DUNLAP PHYSICIANS LLC
Other - Org Name:SOUTHERN OREGON SPINE AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HENSON DUNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:661-713-2652
Mailing Address - Street 1:990 S FRONT ST
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2727
Mailing Address - Country:US
Mailing Address - Phone:541-664-5253
Mailing Address - Fax:541-664-1165
Practice Address - Street 1:990 S FRONT ST
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2727
Practice Address - Country:US
Practice Address - Phone:541-664-5253
Practice Address - Fax:541-664-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5663111N00000X
OR5664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty