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General NPI Number Information
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NPI Number | 1184631970
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Entity Type | Individual
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Provider Name | PACIFICO DORADO MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 2213 SOUTH 9TH STREET
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City | IRONTON
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State | OH
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Zip | 45638
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Country | US
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Telephone | 740-532-6634
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Fax |
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Provider Business Mailing Address
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Address Line | 2213 SOUTH 9TH STREET
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City | IRONTON
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State | OH
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Zip | 45638
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Country | US
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Telephone | 740-532-6634
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35034105
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 20404
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License Number State | KY
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