Provider Demographics
NPI:1710359120
Name:DOIG, IAN
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:DOIG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 SHELBURNE RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4919
Mailing Address - Country:US
Mailing Address - Phone:802-864-8154
Mailing Address - Fax:802-660-8774
Practice Address - Street 1:308 SHELBURNE RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4919
Practice Address - Country:US
Practice Address - Phone:802-864-8154
Practice Address - Fax:802-660-8774
Is Sole Proprietor?:No
Enumeration Date:2015-10-25
Last Update Date:2019-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0003680183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist