| Doctor Name: | MR. DOUGLAS EVERETT DILLON |
| NPI Number: | 1215190350 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FPMHNP |
| License Number: | 723752 |
| Business Practice Address: | 110 W. Ent. Ave Attn 21 Mdos/sgoh- Mental Health Peterson Afb, CO - 809141540 |
| Business Phone Number: | 7194572273 |
| Business Fax Number: | 7195567399 |
| Mailing Address: | 110 W. Ent. Ave, Attn 21 Mdos/sgoh- Mental Health PETERSON AFB |
| State: | CO |
| Postal Code: | 809141540 |
| Phone Number: | 7194572273 |
| Fax Number: | 7195567399 |
| NPI Enumeration Date: | 07/09/2008 |
| NPI Last Update Date: | 02/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 723752 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |