Provider Demographics
NPI:1780647248
Name:DOEBLIN, JANE KRAUSE (MD)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:KRAUSE
Last Name:DOEBLIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 CLINTON AVE S
Mailing Address - Street 2:SUITE 610
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5720
Mailing Address - Country:US
Mailing Address - Phone:585-244-3430
Mailing Address - Fax:
Practice Address - Street 1:1815 S CLINTON AVE
Practice Address - Street 2:SUITE 610
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5720
Practice Address - Country:US
Practice Address - Phone:585-244-3430
Practice Address - Fax:585-244-7811
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185545207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000917435002OtherBC/BS OF WESTERN NEW YORK
NY5705335OtherAETNA
NY9526692OtherGHI
NY102661CKOtherPREFERRED CARE
NY000917435003OtherBC/BS OF WESTERN NEW YORK
NY2703OtherBC/BS
NY01685083Medicaid
NY010185545OtherBLUE CHOICE
NY000917435001OtherBC/BS OF WESTERN NEW YORK
NY160052750OtherRAILROAD
NY000917435003OtherBC/BS OF WESTERN NEW YORK
NY2703OtherBC/BS