Provider Demographics
NPI:1568569713
Name:DUNNICK, JAMES S (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:DUNNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 BURGUNDY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-3403
Mailing Address - Country:US
Mailing Address - Phone:504-512-0188
Mailing Address - Fax:
Practice Address - Street 1:531 BURGUNDY ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3403
Practice Address - Country:US
Practice Address - Phone:504-512-0188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12567R207RC0000X
IN01031539207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100377360Medicaid
LA1541389Medicaid
LA1541389Medicaid
IN100377360Medicaid
LA060067093Medicare PIN
LA5A408D048Medicare PIN
IN184520SSSMedicare PIN