Provider Demographics
NPI:1295863108
Name:DULL, CHRISTOPHER J (MD, JD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:J
Last Name:DULL
Suffix:
Gender:M
Credentials:MD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9755 SOARING HAWK CIR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-9789
Mailing Address - Country:US
Mailing Address - Phone:615-483-1270
Mailing Address - Fax:
Practice Address - Street 1:1650 W OAK ST STE 207
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-3836
Practice Address - Country:US
Practice Address - Phone:317-995-9256
Practice Address - Fax:615-265-0805
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN398962084P0800X
IN01076418A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300007026Medicaid