# DR. ANDY R DILLINGHAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1558531665
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02003103A | IN | Yes |

## Other

- **Enumeration date:** 03/04/2008
- **Last updated:** 01/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200900710 | — | IN |
| 01 | — | 351747218105 | TRICARE | — |