MEDICARE: JANE KRAUSE DOEBLIN M.D.

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	207V00000X	Obstetrics & Gynecology Physician	185545	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000917435002	OTHER	NY	BC/BS OF WESTERN NEW YORK
2	5705335	OTHER	NY	AETNA
3	9526692	OTHER	NY	GHI
4	102661CK	OTHER	NY	PREFERRED CARE
5	000917435003	OTHER	NY	BC/BS OF WESTERN NEW YORK
6	2703	OTHER	NY	BC/BS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	010185545	OTHER	NY	BLUE CHOICE
9	000917435001	OTHER	NY	BC/BS OF WESTERN NEW YORK
10	160052750	OTHER	NY	RAILROAD

General Provider Information

NPI Number	:	1780647248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE KRAUSE DOEBLIN M.D.

Provider Business Mailing Address
First Line	:	1815 CLINTON AVE S
Second Line	:	SUITE 610
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5720
Country	:	US
Telephone Number	:	585-244-3430
Fax Number	:

Provider Business Practice Location Address
First Line	:	1815 S CLINTON AVE
Second Line	:	SUITE 610
City	:	ROCHESTER
State	:	NY
Zip	:	14618-5720
Country	:	US
Telephone Number	:	585-244-3430
Fax Number	:	585-244-7811

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

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	07/08/2007

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