Provider Demographics
NPI:1538181953
Name:DUNEGAN, KATHERINE H (PT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:H
Last Name:DUNEGAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:CORD
Mailing Address - State:AR
Mailing Address - Zip Code:72524-0001
Mailing Address - Country:US
Mailing Address - Phone:870-799-2717
Mailing Address - Fax:
Practice Address - Street 1:1310 SIDNEY ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7628
Practice Address - Country:US
Practice Address - Phone:870-612-7200
Practice Address - Fax:870-612-7203
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT2428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR140645721Medicaid
AR5U947OtherAR BCBS