Duane a Gillam

NPI #1902045446 in Lafayette, Indiana

Provider Information

NPI Number: 1902045446
Entity Type: Organization
Organization Name: Duane a Gillam
Primary Specialty: Optometrist
Enumeration Date: Feb 6, 2009
Last Updated: May 24, 2016

Practice Location

Address: 638 S EARL AVE
City: Lafayette
State: Indiana
ZIP Code: 47904-3264
Phone: (765) 448-2711

Authorized Official

Name: DUANE A GILLAM, OD
Title: OWNER
Phone: (765) 448-2711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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