Healthcare Provider Details

I. General information

NPI: 1003802760
Provider Name (Legal Business Name): JEFFERY JUDE DUNKELBERGER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 04/14/2022
Certification Date: 04/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 N ENOLA RD
ENOLA PA
17025-2123
US

IV. Provider business mailing address

7 DOCK HILL RD
MIDDLEBURG PA
17842-8910
US

V. Phone/Fax

Practice location:
  • Phone: 717-732-4911
  • Fax: 717-409-8948
Mailing address:
  • Phone: 570-837-2123
  • Fax: 570-837-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS009430L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: