1568601599 NPI number — DUNHOPEN ADVENTURES, INC.

Table of content: (NPI 1568601599)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568601599 NPI number — DUNHOPEN ADVENTURES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUNHOPEN ADVENTURES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
W. R. WEBB, D.C.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568601599
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
134 MARION AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCCOMB
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39648-3620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-684-2683
Provider Business Mailing Address Fax Number:
601-684-6759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
134 MARION AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCCOMB
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39648-3620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-684-2683
Provider Business Practice Location Address Fax Number:
601-684-6759
Provider Enumeration Date:
02/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
WEBB
Authorized Official First Name:
WILLIE
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
601-684-2683

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  523 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00115214 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5235223 . This is a "THERAPEUTIC MODALITIES" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 302G705556 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".




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