Provider Demographics
NPI:1144482241
Name:DUNNIGAN, GEORGE M (8018916423)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:M
Last Name:DUNNIGAN
Suffix:
Gender:M
Credentials:8018916423
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 ISLAND VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-3203
Mailing Address - Country:US
Mailing Address - Phone:801-891-6423
Mailing Address - Fax:
Practice Address - Street 1:503 ISLAND VIEW CIR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-3203
Practice Address - Country:US
Practice Address - Phone:801-891-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12443635011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical