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General NPI Number Information
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NPI Number | 1083151278
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Entity Type | Organization
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Legal Business Name | DORAN OPTOMETRY, PLLC
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 20070 ASHBROOK COMMONS PLZ STE 186
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City | ASHBURN
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State | VA
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Zip | 20147-5034
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Country | US
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Telephone | 703-729-8007
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Fax | 703-729-9044
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Provider Business Mailing Address
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Address Line | 20070 ASHBROOK COMMONS PLZ STE 186
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City | ASHBURN
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State | VA
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Zip | 20147-5034
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Country | US
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Telephone | 703-729-8007
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Fax | 703-729-9044
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. RYAN WILLIAM DORAN
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Credential | O.D.
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Telephone | 703-729-8007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618002097
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License Number State | VA
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