Basic Information
Provider Information | |||||||||
NPI: | 1710264049 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | DOPPLER DIAGNOSTICS, INC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1692 WALNUT BOTTOM RD | ||||||||
Address2: |   | ||||||||
City: | NEWVILLE | ||||||||
State: | PA | ||||||||
PostalCode: | 172419520 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7179799701 | ||||||||
FaxNumber: | 7177766726 | ||||||||
Practice Location | |||||||||
Address1: | 757 NORLAND AVE | ||||||||
Address2: | SUITE 104 | ||||||||
City: | CHAMBERSBURG | ||||||||
State: | PA | ||||||||
PostalCode: | 172014230 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7172176800 | ||||||||
FaxNumber: | 7172176900 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 11/15/2011 | ||||||||
LastUpdateDate: | 11/15/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SWIGART | ||||||||
AuthorizedOfficialFirstName: | DONALD | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
AuthorizedOfficialTelephone: | 7179799701 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 293D00000X |   |   | Y |   | Laboratories | Physiological Laboratory |   |
No ID Information.