MEDICARE: RICHARD BRUCE DOERFLER MD

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	2085R0202X	Diagnostic Radiology Physician	35040119	OH

General Provider Information

NPI Number	:	1669455689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD BRUCE DOERFLER MD

Provider Business Mailing Address
First Line	:	232 MILLER ST
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40507-1037
Country	:	US
Telephone Number	:	419-460-0092
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 MILLER ST
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40507-1037
Country	:	US
Telephone Number	:	419-460-0092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	07/09/2021

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