Provider Demographics
NPI:1194767426
Name:DUANE P DILLING
Entity type:Organization
Organization Name:DUANE P DILLING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:P
Authorized Official - Last Name:DILLING
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-766-3485
Mailing Address - Street 1:2230 WOODBURY PIKE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LOYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16659-9506
Mailing Address - Country:US
Mailing Address - Phone:814-766-3485
Mailing Address - Fax:814-766-2379
Practice Address - Street 1:2230 WOODBURY PIKE
Practice Address - Street 2:SUITE 2
Practice Address - City:LOYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16659-9506
Practice Address - Country:US
Practice Address - Phone:814-766-3485
Practice Address - Fax:814-766-2379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005846L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14530OtherUPMC
PA001308770OtherHIGHMARK
PA001115317Medicaid
PA001308770OtherHIGHMARK
PA001115317Medicaid