Provider Demographics
NPI:1538634837
Name:DUNAGAN BETHEA, COURTNEY (PA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:DUNAGAN BETHEA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:L
Other - Last Name:DUNAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:PO BOX 21850
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-1850
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:128 HARMONY PARK CIR STE 100
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS NATIONAL PARK
Practice Address - State:AR
Practice Address - Zip Code:71913-5404
Practice Address - Country:US
Practice Address - Phone:501-881-4988
Practice Address - Fax:501-881-4755
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-805363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant