Provider Demographics
NPI:1548370992
Name:DULANEY, BETTY JO (MD)
Entity type:Individual
Prefix:DR
First Name:BETTY JO
Middle Name:
Last Name:DULANEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 JUDICIAL DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3824
Mailing Address - Country:US
Mailing Address - Phone:901-309-6745
Mailing Address - Fax:901-309-6758
Practice Address - Street 1:2157 JUDICIAL DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3824
Practice Address - Country:US
Practice Address - Phone:901-309-6745
Practice Address - Fax:901-309-6758
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0040096207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNI45099Medicare UPIN
TN33351541Medicare PIN