Individual
DUANE A GILLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
638 S EARL AVE, LAFAYETTE, IN 47904-3264
(765) 448-2711
(765) 448-2995
Mailing address
638 S EARL AVE, LAFAYETTE, IN 47904-3264
(765) 448-2711
(765) 448-2995
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001683B
IN
Other
Enumeration date
07/05/2006
Last updated
04/03/2015
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