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General NPI Number Information
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NPI Number | 1447440060
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Entity Type | Individual
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Provider Name | ELLEN ADELIA DOEBLER PA-C, LRD, CDE
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Gender | Female
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 03/06/2021
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Provider Practice Location Address
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Address Line | 4803 GERRARDSTOWN RD
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City | INWOOD
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State | WV
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Zip | 25428-3450
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Country | US
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Telephone | 304-821-9011
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Fax | 304-821-9012
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Provider Business Mailing Address
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Address Line | 220 CAMPUS BLVD STE 100
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City | WINCHESTER
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State | VA
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Zip | 22601-2888
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Country | US
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Telephone | 540-536-5100
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Fax | 540-536-0235
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110006335
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2064
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License Number State | WV
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