Provider Demographics
NPI:1356633473
Name:DORAN, HENRY G JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:G
Last Name:DORAN
Suffix:JR
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 1:672 BARBOUR ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-3112
Mailing Address - Country:US
Mailing Address - Phone:413-663-7624
Mailing Address - Fax:
Practice Address - Street 1:672 BARBOUR ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-3112
Practice Address - Country:US
Practice Address - Phone:413-663-7624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-08
Last Update Date:2011-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT3296183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist