Basic Information
| Provider Information | |||||||||
| NPI: | 1841627569 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUNFORD | ||||||||
| FirstName: | JUSTIN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2312 REMINGTON WAY | ||||||||
| Address2: | UNIT #3208 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405112275 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592334511 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1101 VETERANS DR | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405022235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592334511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2013 | ||||||||
| LastUpdateDate: | 09/27/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 0579 | KY | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.