Provider Demographics
NPI:1316337975
Name:DUNLAP, DREW
Entity type:Individual
Prefix:
First Name:DREW
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 32 BOX 113
Mailing Address - Street 2:
Mailing Address - City:HASTY
Mailing Address - State:AR
Mailing Address - Zip Code:72640-9705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HC 32 BOX 113
Practice Address - Street 2:
Practice Address - City:HASTY
Practice Address - State:AR
Practice Address - Zip Code:72640-9705
Practice Address - Country:US
Practice Address - Phone:870-688-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator