Basic Information
| Provider Information | |||||||||
| NPI: | 1568601599 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DUNHOPEN ADVENTURES, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | W. R. WEBB, D.C. | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 134 MARION AVE | ||||||||
| Address2: | |||||||||
| City: | MCCOMB | ||||||||
| State: | MS | ||||||||
| PostalCode: | 396483620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016842683 | ||||||||
| FaxNumber: | 6016846759 | ||||||||
| Practice Location | |||||||||
| Address1: | 134 MARION AVE | ||||||||
| Address2: | |||||||||
| City: | MCCOMB | ||||||||
| State: | MS | ||||||||
| PostalCode: | 396483620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016842683 | ||||||||
| FaxNumber: | 6016846759 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2009 | ||||||||
| LastUpdateDate: | 10/18/2010 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | WEBB | ||||||||
| AuthorizedOfficialFirstName: | WILLIE | ||||||||
| AuthorizedOfficialMiddleName: | R. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6016842683 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | D. C. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 523 | MS | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
ID Information
| ID | Type | State | Issuer | Description | 00115214 | 05 | MS | MEDICAID | 5235223 | 01 | MS | THERAPEUTIC MODALITIES | OTHER | 302G705556 | 01 | MS | MEDICARE GROUP PTAN | OTHER |