Provider Demographics
NPI:1760157242
Name:DUNBAR, CALEB MATTHEW
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:MATTHEW
Last Name:DUNBAR
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 1:221 SW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-2335
Mailing Address - Country:US
Mailing Address - Phone:870-886-5700
Mailing Address - Fax:
Practice Address - Street 1:221 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:WALNUT RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72476-2335
Practice Address - Country:US
Practice Address - Phone:870-886-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist