Provider Demographics
NPI:1497842231
Name:DORREL, ERIN D (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:D
Last Name:DORREL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 LYNDON FARM CT STE 300
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5005
Mailing Address - Country:US
Mailing Address - Phone:812-628-3060
Mailing Address - Fax:
Practice Address - Street 1:1260 W COVELL RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-3555
Practice Address - Country:US
Practice Address - Phone:405-471-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX1288870225100000X
OK6261225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00183132OtherRAILROAD MEDICARE
MOR99D494Medicare PIN
KS141144Medicare PIN
KSP00183132OtherRAILROAD MEDICARE
MOW52D494AMedicare PIN
KSW52D494AMedicare PIN
MOR99D494Medicare PIN
KSR99D494Medicare PIN