Provider Demographics
NPI:1700287299
Name:DUNKLIN, EARLINE WILLIAMS
Entity Type:Individual
Prefix:MS
First Name:EARLINE
Middle Name:WILLIAMS
Last Name:DUNKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 N BAYLEN ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-2121
Mailing Address - Country:US
Mailing Address - Phone:850-465-3892
Mailing Address - Fax:
Practice Address - Street 1:1900 N BAYLEN ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2121
Practice Address - Country:US
Practice Address - Phone:850-465-3892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
9999999OtherN/A