Provider Demographics
NPI:1609122712
Name:DOEBLER, ELYANN H (DPM)
Entity Type:Individual
Prefix:
First Name:ELYANN
Middle Name:H
Last Name:DOEBLER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 N WHITE HORSE PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-1866
Mailing Address - Country:US
Mailing Address - Phone:609-704-9001
Mailing Address - Fax:609-704-8316
Practice Address - Street 1:392 N WHITE HORSE PIKE
Practice Address - Street 2:SUITE 102
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-1866
Practice Address - Country:US
Practice Address - Phone:609-704-9001
Practice Address - Fax:609-704-8316
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00314100213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ295563XRXMedicare PIN