Provider Demographics
NPI:1598736522
Name:DOSS, LARRY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:LEE
Last Name:DOSS
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:PO BOX 748
Mailing Address - Street 2:2865 WHEELING ROAD, NE
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-0748
Mailing Address - Country:US
Mailing Address - Phone:740-277-7570
Mailing Address - Fax:740-277-7709
Practice Address - Street 1:2865 WHEELING RD NE
Practice Address - Street 2:HOME CARE PHYSICIAN ONLY
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8508
Practice Address - Country:US
Practice Address - Phone:740-277-7570
Practice Address - Fax:740-277-7709
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-4064-D207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000122834OtherANTHEM SENIOR ADVANTAGE
OH2096600Medicaid
OH5016372OtherAETNA PIN
OH0853014Medicare PIN
OHB50767Medicare UPIN