Provider Demographics
NPI:1003844689
Name:DOKLAN, RAYMOND CLINTON (DC)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:CLINTON
Last Name:DOKLAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1941 BELLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-3744
Mailing Address - Country:US
Mailing Address - Phone:610-799-2489
Mailing Address - Fax:
Practice Address - Street 1:1259 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 317
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6372
Practice Address - Country:US
Practice Address - Phone:610-774-0445
Practice Address - Fax:610-774-0448
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007371L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50044085OtherCAPITAL BLUE CROSS
PA1037855OtherAMERICAN SPECIALITY HEALT
PA757153OtherINDEPENDENT BLUE CROSS
PADO757153OtherHIGHMARK BLUE SHIELD
PA7484644OtherAETNA
PA7484644OtherAETNA
PA053279Medicare ID - Type Unspecified