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General NPI Number Information
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NPI Number | 1891977880
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Entity Type | Organization
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Legal Business Name | JON DOOLEY, O.D., P.C.
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Dates
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Enumeration Date | 11/30/2007
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 1204 N LINCOLN ST
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City | GREENSBURG
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State | IN
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Zip | 47240-1251
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Country | US
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Telephone | 812-663-7015
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Fax | 812-663-7136
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | GREENSBURG
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State | IN
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Zip | 47240-0606
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Country | US
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Telephone | 812-663-7015
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Fax | 812-663-7136
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JON STEVEN DOOLEY
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Credential | O.D.
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Telephone | 812-663-7015
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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 | 56000154
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License Number State | IN
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