Provider Demographics
NPI:1558321570
Name:DOEHNERT, DAVID PAUL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PAUL
Last Name:DOEHNERT
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:615 WASHINGTON ST
Mailing Address - Street 2:MERCY MEDICAL CLINIC
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-1131
Mailing Address - Country:US
Mailing Address - Phone:502-647-4668
Mailing Address - Fax:502-647-4615
Practice Address - Street 1:615 WASHINGTON ST
Practice Address - Street 2:MERCY MEDICAL CLINIC
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1131
Practice Address - Country:US
Practice Address - Phone:502-647-4668
Practice Address - Fax:502-647-4615
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2013-07-27
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYPA1794OtherPA LICENCE