Provider Demographics
NPI:1194773929
Name:DOERR, ANTHONY L (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:L
Last Name:DOERR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8333 N DAVIS HWY
Mailing Address - Street 2:UROLOGY DEPT
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-6050
Mailing Address - Country:US
Mailing Address - Phone:850-474-8398
Mailing Address - Fax:850-969-2962
Practice Address - Street 1:8333 N DAVIS HWY
Practice Address - Street 2:UROLOGY DEPT
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-6050
Practice Address - Country:US
Practice Address - Phone:850-474-8398
Practice Address - Fax:850-969-2962
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT8384208800000X
FLME104914208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0084235Medicaid
MT0084235Medicaid
MTG84192Medicare UPIN