MEDICARE: DR. JACK H DUNN M.D.

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
1	207T00000X	Neurological Surgery Physician	11946	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437139037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACK H DUNN M.D.

Provider Business Mailing Address
First Line	:	P.O. BOX 37020
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85740-7020
Country	:	US
Telephone Number	:	520-299-9660
Fax Number	:	520-529-3629

Provider Business Practice Location Address
First Line	:	1501 N. CAMPBELL AVENUE
Second Line	:	DEPARTMENT OF SURGERY ROOM 4310
City	:	TUCSON
State	:	AZ
Zip	:	85724-5066
Country	:	US
Telephone Number	:	520-250-1140
Fax Number	:	520-529-3629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	04/21/2009

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