Doctor Name: | DR. ERIC LARSON DOANE |
NPI Number: | 1003978529 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | H3242 |
Business Practice Address: | 300 W Hospital Road Eisenhower Army Medical Center, Attn Credentials Fort Gordon, GA - 309055650 |
Business Phone Number: | 7067872183 |
Business Fax Number: | 7067870330 |
Mailing Address: | 300 W Hospital Road, Eisenhower Army Medical Center, Attn Credentials FORT GORDON |
State: | GA |
Postal Code: | 309055650 |
Phone Number: | 7067872183 |
Fax Number: | 7067870330 |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 10/03/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | H3242 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |