Healthcare Provider Details

I. General information

NPI: 1942647946
Provider Name (Legal Business Name): CRAIG DAVID DUNSETH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 N OAKLAND AVE
BOLIVAR MO
65613-3099
US

IV. Provider business mailing address

1500 N OAKLAND AVE
BOLIVAR MO
65613-3011
US

V. Phone/Fax

Practice location:
  • Phone: 417-326-6000
  • Fax: 417-488-7176
Mailing address:
  • Phone: 417-326-6000
  • Fax: 417-488-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberR-9701
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number2019012313
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: