Basic Information
Provider Information
NPI: 1457368409
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNAGAN
FirstName: JAMES
MiddleName: ROY
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 933 BRADBURY SE
Address2: SUITE 2222
City: ALBUQUERQUE
State: NM
PostalCode: 87106
CountryCode: US
TelephoneNumber: 5052723120
FaxNumber: 5052728060
Practice Location
Address1: 1 UNIVERSITY OF NEW MEXICO
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 87131
CountryCode: US
TelephoneNumber: 5052722610
FaxNumber: 5052721300
Other Information
ProviderEnumerationDate: 08/02/2006
LastUpdateDate: 10/05/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X2003-0044NMY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home