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NPI Code Detail

MEDICARE: DR. JOHN C DUNHAM M.D.

MEDICARE: DR. JOHN C DUNHAM 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
1207Q00000XFamily Medicine PhysicianC7475AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10062731OTHERARUMWA H&R FUND
2434592OTHERARHEALTH LINK
354238OTHERARBLUECROSSBLUESHIELD ARK
415354000000OTHERARQUALCHOICE
50790780001OTHERARPALMETTO GBA
6XX12984OTHERARHEALTH PLUS OF MICHIGAN
71670797OTHERARUNITED HEALTHCARE
84211419OTHERARAETNA INSURANCE COMPANY

General Provider Information

NPI Number : 1487624896
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN C DUNHAM M.D.
Provider Business Mailing Address
First Line : PO BOX 668
Second Line :
City : CLARKSVILLE
State : AR
Zip : 72830-0668
Country : US
Telephone Number : 479-754-8384
Fax Number : 479-754-7141
Provider Business Practice Location Address
First Line : 601 W MCKENNON ST
Second Line :
City : CLARKSVILLE
State : AR
Zip : 72830-3523
Country : US
Telephone Number : 479-754-8384
Fax Number : 479-754-7141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2006
Last Update Date : 07/09/2007

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Directions to “ DR. JOHN C DUNHAM M.D.” Practice Location

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