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NPI Code Detail

MEDICARE: EDWIN DUNAWAY O.D.

MEDICARE:   EDWIN  DUNAWAY  O.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
1152W00000XOptometrist2321AR

Other Identifiers

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

General Provider Information

NPI Number : 1679565105
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWIN DUNAWAY O.D.
Provider Business Mailing Address
First Line : 8801 BASELINE RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209-5901
Country : US
Telephone Number : 501-565-2848
Fax Number : 501-565-2724
Provider Business Practice Location Address
First Line : 8801 BASELINE RD
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72209-5901
Country : US
Telephone Number : 501-565-2848
Fax Number : 501-565-2724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 07/08/2007

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Directions to “ EDWIN DUNAWAY O.D.” Practice Location

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