Provider Demographics
NPI:1235636689
Name:DORAN, DANIEL PATRICK (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PATRICK
Last Name:DORAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 STOCKETT RD
Mailing Address - Street 2:
Mailing Address - City:SAND COULEE
Mailing Address - State:MT
Mailing Address - Zip Code:59472-9745
Mailing Address - Country:US
Mailing Address - Phone:406-736-5829
Mailing Address - Fax:
Practice Address - Street 1:590 STOCKETT RD
Practice Address - Street 2:
Practice Address - City:SAND COULEE
Practice Address - State:MT
Practice Address - Zip Code:59472-9745
Practice Address - Country:US
Practice Address - Phone:406-736-5829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT36603336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy