Provider Demographics
NPI:1306114418
Name:DUNBAR, JAMES (CPED)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 DUNCAN CIR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-3559
Mailing Address - Country:US
Mailing Address - Phone:315-601-1455
Mailing Address - Fax:
Practice Address - Street 1:10901 TOM WATSON PKWY
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MO
Practice Address - Zip Code:64152-3991
Practice Address - Country:US
Practice Address - Phone:315-601-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOC50477213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist