Provider Demographics
NPI:1578652681
Name:DOTY, JANETTE R (DC)
Entity Type:Individual
Prefix:MS
First Name:JANETTE
Middle Name:R
Last Name:DOTY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SILVER LADY LANE
Mailing Address - Street 2:
Mailing Address - City:BRANSON WEST
Mailing Address - State:MO
Mailing Address - Zip Code:65737
Mailing Address - Country:US
Mailing Address - Phone:417-272-8484
Mailing Address - Fax:417-272-9797
Practice Address - Street 1:108 SILVER LADY LANE
Practice Address - Street 2:
Practice Address - City:BRANSON WEST
Practice Address - State:MO
Practice Address - Zip Code:65737
Practice Address - Country:US
Practice Address - Phone:417-272-8484
Practice Address - Fax:417-272-9797
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE006671111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO120863OtherBCBS
MO000031616Medicare ID - Type Unspecified
U71878Medicare UPIN