Provider Demographics
NPI:1932112042
Name:DUNN, PAUL DUSTON (MD)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DUSTON
Last Name:DUNN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1301 N RACE ST
Mailing Address - Street 2:1704 WEST STOCKTON STREET
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-3454
Mailing Address - Country:US
Mailing Address - Phone:270-651-4444
Mailing Address - Fax:270-651-4892
Practice Address - Street 1:1704 W STOCKTON ST
Practice Address - Street 2:
Practice Address - City:EDMONTON
Practice Address - State:KY
Practice Address - Zip Code:42129-8137
Practice Address - Country:US
Practice Address - Phone:270-432-4800
Practice Address - Fax:270-432-4804
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY35818207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT424948Medicaid
KY000000259528OtherBLUE CROSS
KY20M1OtherANTHEN
KY64029440Medicaid
KY000000259528OtherBLUE CROSS