Provider Demographics
NPI:1760429492
Name:DOLL, DONALD C (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:C
Last Name:DOLL
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 7687
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65205-7687
Mailing Address - Country:US
Mailing Address - Phone:573-882-2259
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-8445
Practice Address - Fax:573-884-5318
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4F03207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO3600169OtherUNITED HEALTHCARE
MO457193OtherHEALTHLINK
MO2087323201OtherKANSAS MEDICAID
MO10612OtherBLUE SHIELD/BLUE CHOICE
MO202214102Medicaid
A12978Medicare UPIN
MO830001490Medicare PIN
MO966835236Medicare PIN
MOP00415558Medicare PIN
MO10612OtherBLUE SHIELD/BLUE CHOICE
MO152360412Medicare PIN