Provider Demographics
NPI:1013987064
Name:DOOLITTLE, DOAK PETER (MD)
Entity Type:Individual
Prefix:
First Name:DOAK
Middle Name:PETER
Last Name:DOOLITTLE
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 1:807 N ASH ST
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:NE
Mailing Address - Zip Code:69343-1132
Mailing Address - Country:US
Mailing Address - Phone:308-282-1442
Mailing Address - Fax:308-282-1428
Practice Address - Street 1:807 N ASH ST
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:NE
Practice Address - Zip Code:69343-1132
Practice Address - Country:US
Practice Address - Phone:308-282-1442
Practice Address - Fax:308-282-1428
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16268208600000X
KS04-19991208D00000X
MOR8D67208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice