Provider Demographics
NPI:1639467202
Name:DUNSON, DEQUARIUS T
Entity Type:Individual
Prefix:
First Name:DEQUARIUS
Middle Name:T
Last Name:DUNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 320234
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232
Mailing Address - Country:US
Mailing Address - Phone:601-316-1445
Mailing Address - Fax:
Practice Address - Street 1:1084 FLYNT DR
Practice Address - Street 2:SUITE 410
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9736
Practice Address - Country:US
Practice Address - Phone:601-316-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-18
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide