Healthcare Provider Details

I. General information

NPI: 1366545782
Provider Name (Legal Business Name): JOHN EDWARD DOOLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9770 S MCCARRAN BLVD
RENO NV
89523
US

IV. Provider business mailing address

9770 S MCCARRAN BLVD
RENO NV
89523
US

V. Phone/Fax

Practice location:
  • Phone: 775-322-4589
  • Fax: 775-322-3787
Mailing address:
  • Phone: 775-322-4589
  • Fax: 775-322-3787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number3435
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: