Provider Demographics
NPI:1962851741
Name:DOUCETTE, STEPHANYE ALLYSON (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHANYE
Middle Name:ALLYSON
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 KENNEDY MEMORIAL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-4541
Mailing Address - Country:US
Mailing Address - Phone:207-240-0476
Mailing Address - Fax:
Practice Address - Street 1:180 KENNEDY MEMORIAL DR STE 104
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-4541
Practice Address - Country:US
Practice Address - Phone:207-872-5529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-12
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO3043207V00000X
PAOT017291207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology