Provider Demographics
NPI:1083151278
Name:DORAN OPTOMETRY, PLLC
Entity Type:Organization
Organization Name:DORAN OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:DORAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:703-729-8007
Mailing Address - Street 1:20070 ASHBROOK COMMONS PLZ
Mailing Address - Street 2:STE 186
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5034
Mailing Address - Country:US
Mailing Address - Phone:703-729-8007
Mailing Address - Fax:703-729-9044
Practice Address - Street 1:20070 ASHBROOK COMMONS PLZ
Practice Address - Street 2:STE 186
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5034
Practice Address - Country:US
Practice Address - Phone:703-729-8007
Practice Address - Fax:703-729-9044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002097152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty