Basic Information
Provider Information
NPI: 1689751349
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNIGAN
FirstName: RODGER
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 583
Address2:  
City: LOWELL
State: AR
PostalCode: 727450583
CountryCode: US
TelephoneNumber: 8882749585
FaxNumber:  
Practice Location
Address1: 601 W MAPLE AVE
Address2: SUITE 503
City: SPRINGDALE
State: AR
PostalCode: 727645335
CountryCode: US
TelephoneNumber: 4797513722
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/01/2006
LastUpdateDate: 01/31/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XC-8252ARY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


Home