Provider Demographics
NPI:1447546015
Name:DUNSTONE, KENNETH C (MD, MDIV)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:C
Last Name:DUNSTONE
Suffix:
Gender:M
Credentials:MD, MDIV
Other - Prefix:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 SW GAGE BLVD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66622-0001
Mailing Address - Country:US
Mailing Address - Phone:857-350-4335
Mailing Address - Fax:785-350-4414
Practice Address - Street 1:650 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-4030
Practice Address - Country:US
Practice Address - Phone:785-240-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD171452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN