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NPI Code Detail

MEDICARE: MORENIK DUNBAR

MEDICARE: MORENIK DUNBAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyR886188MS

General Provider Information

NPI Number : 1396157665
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORENIK DUNBAR
Provider Business Mailing Address
First Line : PO BOX 9166
Second Line :
City : JACKSON
State : MS
Zip : 39286-9166
Country : US
Telephone Number : 601-982-1986
Fax Number :
Provider Business Practice Location Address
First Line : 5120 GALAXIE DR STE B
Second Line :
City : JACKSON
State : MS
Zip : 39206-4308
Country : US
Telephone Number : 601-982-1986
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2014
Last Update Date : 05/21/2014

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Directions to “ MORENIK DUNBAR ” Practice Location

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