Healthcare Provider Details

I. General information

NPI: 1306460910
Provider Name (Legal Business Name): WILLIAM CRAIG DUNGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2020
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1013 MAR WALT DR STE B
FORT WALTON BEACH FL
32547-6789
US

IV. Provider business mailing address

4800 BELFORT RD 2ND/3RD FLOOR
JACKSONVILLE FL
32256-6004
US

V. Phone/Fax

Practice location:
  • Phone: 904-398-7205
  • Fax:
Mailing address:
  • Phone: 904-398-7205
  • Fax: 904-396-4047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME180230
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.46568
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL84240
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: