MEDICARE: DR. JEFFREY DUANE DUNN PHARM.D., M.B.A.

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	183500000X	Pharmacist	342674-1701	UT

General Provider Information

NPI Number	:	1851310924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY DUANE DUNN PHARM.D., M.B.A.

Provider Business Mailing Address
First Line	:	9502 CARRIAGE CHASE LN
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84092-6309
Country	:	US
Telephone Number	:	801-947-0746
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 LAKE PARK BLVD
Second Line	:	SUITE N3
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84120-8212
Country	:	US
Telephone Number	:	801-442-7984
Fax Number	:	801-442-3006

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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