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General NPI Number Information
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NPI Number | 1932430303
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Entity Type | Organization
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Legal Business Name | DOCTOR AT THE DOOR, PLLC
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Dates
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Enumeration Date | 01/24/2010
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Last Update Date | 01/24/2010
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Provider Practice Location Address
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Address Line | 4124 BOONE CREEK RD
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City | LEXINGTON
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State | KY
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Zip | 40509-9712
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Country | US
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Telephone | 859-608-3074
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Fax | 859-264-7886
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Provider Business Mailing Address
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Address Line | 4124 BOONE CREEK RD
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City | LEXINGTON
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State | KY
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Zip | 40509-9712
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Country | US
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Telephone | 859-608-3074
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Fax | 859-264-7886
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONDAL EARL GOBLE
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Credential | M.D.
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Telephone | 859-608-3074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26176
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License Number State | KY
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