Provider Demographics
NPI:1689810301
Name:DOLPHINDX - PERRY, MI. INC.
Entity Type:Organization
Organization Name:DOLPHINDX - PERRY, MI. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REGULATORY COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-797-8461
Mailing Address - Street 1:4990 NORTHWIND DR STE 122
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5091
Mailing Address - Country:US
Mailing Address - Phone:517-333-7730
Mailing Address - Fax:
Practice Address - Street 1:4990 NORTHWIND DR STE 122
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5091
Practice Address - Country:US
Practice Address - Phone:517-333-7730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Single Specialty