Provider Demographics
NPI:1922366004
Name:DUNHAM, ANDREW K (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:K
Last Name:DUNHAM
Suffix:
Gender:M
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:PO BOX 1331
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-1331
Mailing Address - Country:US
Mailing Address - Phone:870-935-3990
Mailing Address - Fax:870-935-0871
Practice Address - Street 1:800 S CHURCH ST
Practice Address - Street 2:STE. 302
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4176
Practice Address - Country:US
Practice Address - Phone:870-935-3990
Practice Address - Fax:870-935-0871
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2012018700207V00000X
ARE-9709207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program