Provider Demographics
NPI:1225024482
Name:DUNAWAY, JOSEPH DAVID (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DAVID
Last Name:DUNAWAY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23 PROFESSIONAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-4432
Mailing Address - Country:US
Mailing Address - Phone:479-754-4721
Mailing Address - Fax:844-584-4213
Practice Address - Street 1:23 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-4432
Practice Address - Country:US
Practice Address - Phone:479-754-4721
Practice Address - Fax:844-584-4213
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN8374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5J130B690OtherPTAN
AR123417003Medicaid
AR5J130B690Medicare PIN
AR5J130B690OtherPTAN