Provider Demographics
NPI:1245223510
Name:DEHNING, DOUGLAS O (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:O
Last Name:DEHNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 S CLIFF AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-7015
Mailing Address - Country:US
Mailing Address - Phone:816-478-1230
Mailing Address - Fax:816-478-4413
Practice Address - Street 1:4741 COCHISE DR
Practice Address - Street 2:DISCOVER VISION CENTERS
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055
Practice Address - Country:US
Practice Address - Phone:816-478-1230
Practice Address - Fax:816-478-4413
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36472207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
010022560OtherRAILROAD MEDICARE
180038013OtherRAILROAD MEDICARE
B22193Medicare UPIN
4062067Medicare PIN