Provider Demographics
NPI:1336335140
Name:DUNNINGTON, GANSEVOORT HURLBUT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:GANSEVOORT
Middle Name:HURLBUT
Last Name:DUNNINGTON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 7096
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95267-0096
Mailing Address - Country:US
Mailing Address - Phone:209-956-7725
Mailing Address - Fax:209-956-7733
Practice Address - Street 1:10 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-9554
Practice Address - Country:US
Practice Address - Phone:707-963-6445
Practice Address - Fax:707-967-5656
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-15
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
CAA82962208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)