Provider Demographics
NPI:1578609004
Name:DUNN, RICHARD W (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:DUNN
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 1:1 MERCY LN STE 307
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6440
Mailing Address - Country:US
Mailing Address - Phone:501-623-4898
Mailing Address - Fax:501-623-0260
Practice Address - Street 1:1 MERCY LN STE 307
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6440
Practice Address - Country:US
Practice Address - Phone:501-623-4898
Practice Address - Fax:501-623-0260
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4812207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR102407001Medicaid
ARC68196Medicare UPIN
AR51477Medicare ID - Type Unspecified