Provider Demographics
NPI:1558745703
Name:KARL W DUNN PC
Entity Type:Organization
Organization Name:KARL W DUNN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:586-201-1357
Mailing Address - Street 1:2217 BARRITT ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:830 W LAKE LANSING RD
Practice Address - Street 2:SUITE 190
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6371
Practice Address - Country:US
Practice Address - Phone:586-201-1357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002402213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty