Provider Demographics
NPI:1609316280
Name:DUNGEE, CHI
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:
Last Name:DUNGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1464
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-1464
Mailing Address - Country:US
Mailing Address - Phone:918-759-1617
Mailing Address - Fax:
Practice Address - Street 1:14200 N 280 RD
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-1464
Practice Address - Country:US
Practice Address - Phone:918-759-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator