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General NPI Number Information
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NPI Number | 1811371503
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Entity Type | Individual
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Provider Name | DUANE ELSBURY
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Gender | Male
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 07/13/2015
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Provider Practice Location Address
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Address Line | 846 N STATE ST
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City | GREENFIELD
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State | IN
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Zip | 46140-1201
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Country | US
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Telephone | 317-462-3326
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Fax |
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Provider Business Mailing Address
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Address Line | 5385 E 500 N
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City | GREENFIELD
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State | IN
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Zip | 46140-8939
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Country | US
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Telephone | 317-498-5860
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 180003917A
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License Number State | IN
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