Provider Demographics
NPI:1730440603
Name:DUNLAVY, BROOKE A (MD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:A
Last Name:DUNLAVY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 S HARBOUR ISLAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5925
Mailing Address - Country:US
Mailing Address - Phone:800-480-5243
Mailing Address - Fax:800-928-7449
Practice Address - Street 1:7912 E 31ST CT STE 140
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-1346
Practice Address - Country:US
Practice Address - Phone:918-743-8200
Practice Address - Fax:888-987-9649
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9407853207Q00000X
OK42509207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine