Douglas A Duerstock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

18002570B Issued in IN

Practice address

567 Ivy Tech Dr
Madison, IN 47250-1802

Phone

(812) 273-6901

Fax

(812) 265-3275

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871695577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 IVY TECH DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472501802",
            "telephone_number": "812-273-6901",
            "fax_number": "812-265-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 IVY TECH DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472501802",
            "telephone_number": "812-273-6901",
            "fax_number": "812-265-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUERSTOCK",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002570B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Dorsey, OTD,OTR/L
• Douglas a. Duerstock O.D. Inc.
• Heather Faye Downey, LCAC
• Dr. Howard C. Jackson, Inc.
• Dr. Lee Gus Dunker
• Jesse William Duquette
• Nilda E Durany, MD
• E S T Inc
• John M Eagleson, OD
• Thomas C Eckert, M.D.

• Optometrist in Madison, IN
• Providers in Madison, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.