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General NPI Number Information
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NPI Number | 1285673764
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Entity Type | Individual
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Provider Name | GREGORY ROBERT DOLL M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 05/21/2019
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Provider Practice Location Address
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Address Line | 3901 S 7TH ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-5709
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Country | US
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Telephone | 812-232-0021
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Fax |
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Provider Business Mailing Address
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Address Line | 4266 S WILLOWBROOK CT
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City | TERRE HAUTE
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State | IN
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Zip | 47802-8789
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01038616
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 01038616A
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License Number State | IN
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