MEDICARE: L DENNIS DOAN, DC, PLLC

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
1	111N00000X	Chiropractor	3613	OK

General Provider Information

NPI Number	:	1619180478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L DENNIS DOAN, DC, PLLC

Provider Business Mailing Address
First Line	:	12411 N ROCKWELL AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-2704
Country	:	US
Telephone Number	:	405-621-5617
Fax Number	:	405-621-5619

Provider Business Practice Location Address
First Line	:	12411 N ROCKWELL AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-2704
Country	:	US
Telephone Number	:	405-621-5617
Fax Number	:	405-621-5619

Authorized Official
Title or Position	:	OWNER
Name	:	DR. L DENNIS DOAN
Credential	:	DC
Telephone Number	:	405-621-5617

Provider Enumeration Date	:	05/08/2007
Last Update Date	:	08/22/2020

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