Provider Demographics
NPI:1942286174
Name:DUNLOP, JOHN J (DO)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:DUNLOP
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9127 IRIQUOIS TRL
Mailing Address - Street 2:
Mailing Address - City:NEGLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44441-9756
Mailing Address - Country:US
Mailing Address - Phone:330-383-1036
Mailing Address - Fax:330-822-0010
Practice Address - Street 1:9127 IRIQUOIS TRL
Practice Address - Street 2:
Practice Address - City:NEGLEY
Practice Address - State:OH
Practice Address - Zip Code:44441-9756
Practice Address - Country:US
Practice Address - Phone:330-383-1036
Practice Address - Fax:330-822-0010
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2139207P00000X
OH34-004935207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0894091Medicaid
WV0894091Medicaid
E99363Medicare UPIN