Provider Demographics
NPI:1093717654
Name:DOLL, HAROLD AVON JR (MD)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:AVON
Last Name:DOLL
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:2617 MITCHAM DR STE 102
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5479
Mailing Address - Country:US
Mailing Address - Phone:850-878-1171
Mailing Address - Fax:850-942-1291
Practice Address - Street 1:2617 MITCHAM DR STE 102
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5479
Practice Address - Country:US
Practice Address - Phone:850-878-1171
Practice Address - Fax:850-942-1291
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2020-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME48984207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060754100Medicaid
E82557Medicare UPIN
FL052110800Medicare ID - Type Unspecified