Provider Demographics
NPI:1689340994
Name:DUNNING, MADISON IVEY (OD)
Entity Type:Individual
Prefix:MISS
First Name:MADISON
Middle Name:IVEY
Last Name:DUNNING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3810 TREMONT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2835
Mailing Address - Country:US
Mailing Address - Phone:336-269-9029
Mailing Address - Fax:
Practice Address - Street 1:2351 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-684-8961
Practice Address - Fax:919-681-2603
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2678152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation