Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 73546 | GA |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 073546 | GA |
NPI | 1457585192 |
---|---|
Provider Name | Dr. Justin Michael Dunn |
First Address | Rome, GA 30161-4999 |
Second Address | Rome, GA 30161-4999 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2009 |
Last Update Date | 27/07/2015 |