Provider Demographics
NPI:1265471635
Name:DINGUS, DONALD ELMER (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ELMER
Last Name:DINGUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E 19TH ST N
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-3468
Mailing Address - Country:US
Mailing Address - Phone:276-524-4920
Mailing Address - Fax:276-524-1401
Practice Address - Street 1:205 E 19TH ST N
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3468
Practice Address - Country:US
Practice Address - Phone:276-524-4920
Practice Address - Fax:276-524-1401
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101045541207P00000X
TN40295207P00000X
VA0101045541207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E48450Medicare UPIN