Provider Demographics
NPI:1669547626
Name:DUNLOP, WILLIAM E (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:E
Last Name:DUNLOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2342
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105
Mailing Address - Country:US
Mailing Address - Phone:606-327-5628
Mailing Address - Fax:
Practice Address - Street 1:617 23RD ST
Practice Address - Street 2:SUITE 445 MEDICAL PLAZA A
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101
Practice Address - Country:US
Practice Address - Phone:606-327-5628
Practice Address - Fax:606-327-5649
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36647208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64042591Medicaid
H55561Medicare UPIN
KY64042591Medicaid