Provider Demographics
NPI:1760768071
Name:DOOLEY, DENNIS FRANCIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:FRANCIS
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 BLACK BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-1207
Mailing Address - Country:US
Mailing Address - Phone:608-449-3524
Mailing Address - Fax:
Practice Address - Street 1:1933 W COURT ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-3417
Practice Address - Country:US
Practice Address - Phone:608-755-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10822172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker