Healthcare Provider Details

I. General information

NPI: 1083643506
Provider Name (Legal Business Name): JAMES DUNN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/25/2024
Certification Date: 08/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S MOCK ST
PRAIRIE GROVE AR
72753-3146
US

IV. Provider business mailing address

PO BOX 8091
FAYETTEVILLE AR
72703-0001
US

V. Phone/Fax

Practice location:
  • Phone: 479-422-7212
  • Fax: 479-345-5376
Mailing address:
  • Phone: 479-422-7212
  • Fax: 479-345-5376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE-0931
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: