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Individual

LESTER DORNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3290 VILLAGE DR, MIDDLETOWN, OH 45005
(513) 622-7703
(513) 424-7704
Mailing address
3290 VILLAGE DR, MIDDLETOWN, OH 45005
(513) 622-7703
(513) 424-7704

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35058512D
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000246117
UNICARE
OH
01
108085
NATIONWIDE HEALTH PLAN
OH
05
2356856
OH
01
35058512D
MEDICAL LICENSE
OH
01
452360001
CARESOURCE
OH
01
7550431
AETNA
OH
01
D5851201
HUMANA/CHOICECARE
OH
01
P00004510
RAILROAD MEDICARE
OH
Enumeration date
05/30/2005
Last updated
09/01/2009
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