# DOROTHY B. LOLLATHIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1932139839
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 10003160A | IN | Yes |
| 363A00000X | Physician Assistant | 50.002298RX | OH | — |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 05/17/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000175652 | ANTHEM BCBS | — |
| 01 | — | 000000181581 | UNISON MEDICAID | OH |
| 01 | — | 001769308 | MOUNTAIN STATE BCBS | — |
| 05 | — | 0075679 | — | OH |
| 01 | — | 0498377 | MOLINA MEDICAID | OH |
| 05 | — | 1068920 | — | WV |
| 01 | — | 293560617 | TRI CARE | OH |
| 01 | — | P00278526 | RR MEDICARE | — |