Georgia K Dorulla, MD
Individual provider Active NPI Diagnostic Radiology Physician · Beech Grove, IN
NPI 1700870722 · NPPES record last updated Jan 9, 2008
Key facts
- NPI
- 1700870722
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 1042298 (IN)
- Practice address
- 1500 Albany St
Suite 906
Beech Grove, IN 46107-1557 - Phone
- (317) 787-3296
- Fax
- (317) 783-4107
- NPI assigned
- Sep 6, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1042298 | IN | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology of Indiana P C | Diagnostic Radiology | Past | Accepting new patients |
| American Health Network of Indiana, LLC | Diagnostic Radiology | Past | Accepting new patients |
| American Health Network of Indiana, LLC | Diagnostic Radiology | Past | Accepting new patients |
| American Health Network of Indiana LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 1042298 | IN | Yes |
Addresses
Primary practice location
1500 Albany St
Suite 906
Beech Grove, IN 46107-1557
Mailing address
1500 Albany St
Suite 906
Beech Grove, IN 46107-1557
Phone (317) 787-3296
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00032566 | Other | RAILROAD MEDICARE | |
| P00408569 | Other | RAILROAD MEDICARE | |
| P00033126 | Other | RAILROAD MEDICARE | |
| P00033113 | Other | RAILROAD MEDICARE | |
| P00033114 | Other | RAILROAD MEDICARE | |
| P00032765 | Other | RAILROAD MEDICARE | |
| P00033093 | Other | RAILROAD MEDICARE | |
| 000000109950 | Other | IN | ANTHEM |
| P00032884 | Other | RAILROAD MEDICARE | |
| P00032561 | Other | RAILROAD MEDICARE | |
| P00032996 | Other | RAILROAD MEDICARE | |
| P00032995 | Other | RAILROAD MEDICARE | |
| P00033075 | Other | RAILROAD MEDICARE |
Other providers in Beech Grove, IN
- Kathleen Lynn Cowden
- David J. Black, MD, LLC
- Chad Eric Deerberg
- Barbara Dempsey
- Jeri Dine
- Doug Taylor Prosthetics Inc
- Paul E Driscoll
- Kailyn Loren Duane
- James Dycus
- Abigail Nicole Emerick
All providers in Beech Grove, IN · Diagnostic Radiology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.