Provider Demographics
NPI:1275971129
Name:DOOLIN, ASHLEY K (OD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:K
Last Name:DOOLIN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:K
Other - Last Name:VUKELICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:70 E 68TH PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-3506
Mailing Address - Country:US
Mailing Address - Phone:219-736-2020
Mailing Address - Fax:219-769-3884
Practice Address - Street 1:10751 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7615
Practice Address - Country:US
Practice Address - Phone:219-226-9477
Practice Address - Fax:219-226-9481
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003862B152W00000X
IN18003862A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201243480Medicaid