Provider Demographics
NPI:1598982316
Name:DOERING, HENRY B (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:B
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 1:1133 COLLEGE AVE. BLDG E-220
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2777
Mailing Address - Country:US
Mailing Address - Phone:785-539-5341
Mailing Address - Fax:785-539-1238
Practice Address - Street 1:1133 COLLEGE AVE. BLDG E-220
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2777
Practice Address - Country:US
Practice Address - Phone:785-539-5341
Practice Address - Fax:785-539-1238
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6374208600000X
KS04-32881208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200654690AMedicaid
KS200654690AMedicaid
003921001Medicare PIN