Provider Demographics
NPI:1629130604
Name:DUNLAP, WILLIAM JEFFREY JR (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JEFFREY
Last Name:DUNLAP
Suffix:JR
Gender:M
Credentials:DO
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Mailing Address - Street 1:650 JOEL DR
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5318
Mailing Address - Country:US
Mailing Address - Phone:270-461-5044
Mailing Address - Fax:931-645-4104
Practice Address - Street 1:650 JOEL DR
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-461-5044
Practice Address - Fax:931-645-4104
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2018-12-06
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Provider Licenses
StateLicense IDTaxonomies
ALDO.931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAVAD000Medicare UPIN