Basic Information
| Provider Information | |||||||||
| NPI: | 1407813025 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOERING | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 315 E BROADWAY | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026292500 | ||||||||
| FaxNumber: | 5026293166 | ||||||||
| Practice Location | |||||||||
| Address1: | 3991 DUTCHMANS LN | ||||||||
| Address2: | SUITE 405 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028993366 | ||||||||
| FaxNumber: | 5028993455 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2006 | ||||||||
| LastUpdateDate: | 01/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0201X | 28408 | KY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
ID Information
| ID | Type | State | Issuer | Description | 100332410 | 05 | IN | MEDICAID | 2633890 | 01 | KY | CIGNA PROVIDER NUMB | OTHER | 4139290 | 01 | KY | AETNA PROVIDER NUMBER | OTHER | 000000074658 | 01 | KY | ANTHEM PROVIDER NUMB | OTHER | 64284086 | 05 | KY | MEDICAID | 000020583F | 01 | KY | HUMANA PROVIDER NUMB | OTHER | 1112294 | 01 | KY | PASSPORT PROVIDER NUMB | OTHER | 160048070 | 01 | KY | RAILROAD MEDICARE | OTHER | E91512 | 01 | KY | UPIN PROVIDER NUMB | OTHER |