Individual
DR. DAVID I. DOORENBOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-3074
Mailing address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-3074
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
11711
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115728
—
MS
01
—
73069371
BLUE CROSS OF AL
AL
Enumeration date
08/19/2005
Last updated
07/08/2007
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