Provider Demographics
NPI:1225173883
Name:HULSEY, DONALD H (OD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:HULSEY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 MACY WAY
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-7483
Mailing Address - Country:US
Mailing Address - Phone:317-888-8508
Mailing Address - Fax:
Practice Address - Street 1:10610 N PENNSYLVANIA ST
Practice Address - Street 2:STE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46280-2000
Practice Address - Country:US
Practice Address - Phone:317-844-6269
Practice Address - Fax:317-815-7567
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002572A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U56439Medicare UPIN
266660DMedicare ID - Type Unspecified