Healthcare Provider Details

I. General information

NPI: 1275971129
Provider Name (Legal Business Name): ASHLEY K DOOLIN OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY K VUKELICH OD

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10751 RANDOLPH ST
CROWN POINT IN
46307-7615
US

IV. Provider business mailing address

70 E 68TH PL
MERRILLVILLE IN
46410-3506
US

V. Phone/Fax

Practice location:
  • Phone: 219-226-9477
  • Fax: 219-226-9481
Mailing address:
  • Phone: 219-736-2020
  • Fax: 219-769-3884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003862B
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003862A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: