Provider Demographics
NPI:1093019093
Name:DAVANAND DOODNAUTH,M.D., PSC
Entity Type:Organization
Organization Name:DAVANAND DOODNAUTH,M.D., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVANAND
Authorized Official - Middle Name:
Authorized Official - Last Name:DOODANUTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:859-523-0732
Mailing Address - Street 1:PO BOX 911014
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1014
Mailing Address - Country:US
Mailing Address - Phone:859-523-0732
Mailing Address - Fax:859-523-1946
Practice Address - Street 1:1050 MONARCH ST STE 300
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1877
Practice Address - Country:US
Practice Address - Phone:859-286-9951
Practice Address - Fax:859-286-9952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207R00000X, 235Z00000X, 363AM0700X, 363L00000X
KY40574282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty