Provider Demographics
NPI:1649569609
Name:DILLON, DUSTIN WEBB (MD)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:WEBB
Last Name:DILLON
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 1:2052 SHERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205
Mailing Address - Country:US
Mailing Address - Phone:270-339-8403
Mailing Address - Fax:
Practice Address - Street 1:3532 EPHRAIM MCDOWELL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3224
Practice Address - Country:US
Practice Address - Phone:502-456-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY498332080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine