Provider Demographics
NPI:1245676113
Name:DORAN, STACEY LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:LYNN
Last Name:DORAN
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 1:2125 BLUEGRAMA DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UC DEPT OF SURGERY
Practice Address - Street 2:231 ALBERT SABIN WAY
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0558
Practice Address - Country:US
Practice Address - Phone:531-558-5861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program