Provider Demographics
NPI:1487624896
Name:DUNHAM, JOHN C (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:DUNHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 668
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72830-0668
Mailing Address - Country:US
Mailing Address - Phone:479-754-8384
Mailing Address - Fax:479-754-7141
Practice Address - Street 1:601 W MCKENNON ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72830-3523
Practice Address - Country:US
Practice Address - Phone:479-754-8384
Practice Address - Fax:479-754-7141
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARC7475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR0062731OtherUMWA H&R FUND
AR434592OtherHEALTH LINK
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AR15354000000OtherQUALCHOICE
AR0790780001OtherPALMETTO GBA
ARXX12984OtherHEALTH PLUS OF MICHIGAN
AR1670797OtherUNITED HEALTHCARE
AR4211419OtherAETNA INSURANCE COMPANY
AR434592OtherHEALTH LINK