Provider Demographics
NPI:1659306751
Name:DOLL, DAVID J (DC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:DOLL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 N MIDKIFF RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-2132
Mailing Address - Country:US
Mailing Address - Phone:432-520-0773
Mailing Address - Fax:432-520-0774
Practice Address - Street 1:1220 N MIDKIFF RD
Practice Address - Street 2:SUITE B
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-2132
Practice Address - Country:US
Practice Address - Phone:432-520-0773
Practice Address - Fax:432-520-0774
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9064111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
00X619Medicare PIN
TX8B6190Medicare ID - Type UnspecifiedMIDLAND MEDICARE NUMBER
TXU95542Medicare UPIN