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NPI Code Detail

MEDICARE: DONALD ROBERT DORAN JR. D.O.

MEDICARE:   DONALD ROBERT DORAN JR. D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianD73658MS
2207Q00000XFamily Medicine Physician15548MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518906734
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD ROBERT DORAN JR. D.O.
Provider Business Mailing Address
First Line : PO BOX 1007
Second Line :
City : LUCEDALE
State : MS
Zip : 39452-1007
Country : US
Telephone Number : 601-528-9119
Fax Number : 601-528-9193
Provider Business Practice Location Address
First Line : 975 HALL ST
Second Line :
City : WIGGINS
State : MS
Zip : 39577-2107
Country : US
Telephone Number : 601-528-9119
Fax Number : 601-528-9193
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2006
Last Update Date : 05/10/2017

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