Provider Demographics
NPI:1346640448
Name:DOCTOR, DANE MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANE
Middle Name:MICHAEL
Last Name:DOCTOR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:ANESTHESIOLOGY - N202
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-218-0069
Mailing Address - Fax:859-323-1080
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:ANESTHESIOLOGY - N202
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-218-0069
Practice Address - Fax:859-323-1080
Is Sole Proprietor?:No
Enumeration Date:2014-08-26
Last Update Date:2018-06-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KYTP631207L00000X
KYR3471207L00000X
KY51428207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology