Provider Demographics
NPI:1073793576
Name:DION J DULAY, MD, PC
Entity Type:Organization
Organization Name:DION J DULAY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DION
Authorized Official - Middle Name:J
Authorized Official - Last Name:DULAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-476-1462
Mailing Address - Street 1:5200 WASHINGTON AVE
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4863
Mailing Address - Country:US
Mailing Address - Phone:812-476-1462
Mailing Address - Fax:812-473-3938
Practice Address - Street 1:5200 WASHINGTON AVE
Practice Address - Street 2:SUITE 3000
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-4863
Practice Address - Country:US
Practice Address - Phone:812-476-1462
Practice Address - Fax:812-473-3938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031016152WC0802X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100246730AMedicaid
IN0989540001OtherDMERC REGION B
IN0989540001Medicare NSC
IN100246730AMedicaid