Basic Information
Provider Information
NPI: 1326473802
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNLAP
FirstName: HEATHER
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1272 GARRISON DR
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371292598
CountryCode: US
TelephoneNumber: 6158934480
FaxNumber: 6158956212
Practice Location
Address1: 1272 GARRISON DR
Address2:  
City: MURFREESBORO
State: TN
PostalCode: 371292598
CountryCode: US
TelephoneNumber: 6158934480
FaxNumber: 6158956212
Other Information
ProviderEnumerationDate: 09/04/2013
LastUpdateDate: 06/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000X390200000OHN Allopathic & Osteopathic PhysiciansSurgery 
208600000XDO3454TNY Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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