Provider Demographics
NPI:1407813025
Name:DOERING, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:DOERING
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 1:315 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1703
Mailing Address - Country:US
Mailing Address - Phone:502-629-2500
Mailing Address - Fax:502-629-3166
Practice Address - Street 1:3991 DUTCHMANS LN
Practice Address - Street 2:SUITE 405
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4700
Practice Address - Country:US
Practice Address - Phone:502-899-3366
Practice Address - Fax:502-899-3455
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28408207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100332410Medicaid
KY2633890OtherCIGNA PROVIDER NUMB
KY4139290OtherAETNA PROVIDER NUMBER
KY000000074658OtherANTHEM PROVIDER NUMB
KY64284086Medicaid
KY000020583FOtherHUMANA PROVIDER NUMB
KY1112294OtherPASSPORT PROVIDER NUMB
KY160048070OtherRAILROAD MEDICARE
KYE91512OtherUPIN PROVIDER NUMB
KY0299007Medicare PIN
KY64284086Medicaid
KY000020583FOtherHUMANA PROVIDER NUMB