Provider Demographics
NPI:1982624268
Name:DUNAWAY, TODD B (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:B
Last Name:DUNAWAY
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 1:1919 S WHEELING AVE
Mailing Address - Street 2:SUITE 707
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5638
Mailing Address - Country:US
Mailing Address - Phone:918-747-7517
Mailing Address - Fax:918-742-7947
Practice Address - Street 1:1919 S WHEELING AVE
Practice Address - Street 2:SUITE 707
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5638
Practice Address - Country:US
Practice Address - Phone:918-747-7517
Practice Address - Fax:918-742-7947
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK232282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2413253101Medicare PIN