Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 32826 | KY |
N | 111NI0900X | Internist | 32826 | KY |
N | 207RC0200X | Critical Care Medicine | 32826 | KY |
Y | 207RP1001X | Pulmonary Disease | 32826 | KY |
NPI | 1053328880 |
---|---|
Provider Name | Dennis Edwin Doherty |
First Address | Lexington, KY 40508-3215 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 30/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64328263 | (05) | KY |
G43694 | (02) |