Provider Demographics
NPI:1891132569
Name:DUNAWAY, JOHN ARNOLD
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ARNOLD
Last Name:DUNAWAY
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 1:802 NW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-4644
Mailing Address - Country:US
Mailing Address - Phone:580-581-1730
Mailing Address - Fax:580-355-2902
Practice Address - Street 1:802 NW 53RD ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-4644
Practice Address - Country:US
Practice Address - Phone:580-581-1730
Practice Address - Fax:580-355-9406
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor