Healthcare Provider Details

I. General information

NPI: 1831325166
Provider Name (Legal Business Name): JOHN M DUNDON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BILBY RD SUITE 201
HACKETTSTOWN NJ
07840-4174
US

IV. Provider business mailing address

108 BILBY RD SUITE 201
HACKETTSTOWN NJ
07840-4174
US

V. Phone/Fax

Practice location:
  • Phone: 908-684-3005
  • Fax:
Mailing address:
  • Phone: 908-684-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number25MA09788000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number278927
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: