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Individual
DR. C. RANDALL DOAN
Active
Individual
DR. C. RANDALL DOAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
15013
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
15013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0472653
—
OH
01
—
43-00059
UNITED HEALTHCARE
OH
01
—
487716
UNITED CONCORDIA
OH
Enumeration date
02/27/2006
Last updated
02/08/2011
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