Active NPI
Earl Edgar Dunkleberger, P.A.
- Medical Physician Assistant
- Holdenville, OK
National Provider Identifier
1366577843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 294
- Practice address
- 100 McDougal Dr
Holdenville, OK 74848-2822 - Phone
- (405) 379-4201
- Fax
- (405) 379-4252
- NPI assigned
- Feb 23, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 294 | OK | Primary |
Addresses
Primary practice location
100 McDougal Dr
Holdenville, OK 74848-2822
Mailing address
100 McDougal Dr
Holdenville, OK 74848-2822
Phone (405) 379-4201
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 294 | OK | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366577843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MCDOUGAL DR",
"city": "HOLDENVILLE",
"state": "OK",
"postal_code": "748482822",
"telephone_number": "405-379-4201",
"fax_number": "405-379-4252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MCDOUGAL DR",
"city": "HOLDENVILLE",
"state": "OK",
"postal_code": "748482822",
"telephone_number": "405-379-4201",
"fax_number": "405-379-4252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNKLEBERGER",
"first_name": "EARL",
"middle_name": "EDGAR",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "OK",
"license": "294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holdenville, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.