Provider Demographics
NPI:1063115392
Name:DUNNAM, JOSEPH RAY
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RAY
Last Name:DUNNAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:DUNNAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1401 PROVIDENCE PARK STE 200
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4694
Mailing Address - Country:US
Mailing Address - Phone:205-306-1907
Mailing Address - Fax:
Practice Address - Street 1:1401 PROVIDENCE PARK STE 200
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-4694
Practice Address - Country:US
Practice Address - Phone:205-306-1907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide