Provider Demographics
NPI:1205250271
Name:ASAY, DUSTIN L (OD)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:L
Last Name:ASAY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-8701
Mailing Address - Country:US
Mailing Address - Phone:970-669-1107
Mailing Address - Fax:970-669-8849
Practice Address - Street 1:3650 E 15TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-8701
Practice Address - Country:US
Practice Address - Phone:970-669-1107
Practice Address - Fax:970-669-8849
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY354T152W00000X
COOPT.0003352152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist