Healthcare Provider Details

I. General information

NPI: 1154433290
Provider Name (Legal Business Name): ROBERT EHREN DOTY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16601 N 40TH ST STE 125
PHOENIX AZ
85032-3355
US

IV. Provider business mailing address

20803 N 38TH ST
PHOENIX AZ
85050-4871
US

V. Phone/Fax

Practice location:
  • Phone: 480-292-1735
  • Fax: 480-383-6516
Mailing address:
  • Phone: 480-292-1735
  • Fax: 480-383-6516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7669
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number4349
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: