Healthcare Provider Details

I. General information

NPI: 1871524694
Provider Name (Legal Business Name): GEOFFREY PARKER DUNN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 STATE ST HAMOT FACULTY SPECIALISTS
ERIE PA
16550-0002
US

IV. Provider business mailing address

717 STATE ST STE 16 REGIONAL HEALTH SERVICES
ERIE PA
16501-1341
US

V. Phone/Fax

Practice location:
  • Phone: 814-877-4922
  • Fax: 814-877-3622
Mailing address:
  • Phone: 814-877-7100
  • Fax: 814-877-2939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD30831E
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License NumberMD30831E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: