Healthcare Provider Details

I. General information

NPI: 1265817845
Provider Name (Legal Business Name): MARSHA DUNKLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2015
Last Update Date: 05/20/2022
Certification Date: 05/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1923 N DAL PASO ST STE A
HOBBS NM
88240-3023
US

IV. Provider business mailing address

1600 N MAIN AVE
LOVINGTON NM
88260-2871
US

V. Phone/Fax

Practice location:
  • Phone: 575-433-3000
  • Fax:
Mailing address:
  • Phone: 575-396-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036144778
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2022-0206
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: