Provider Demographics
NPI:1588700272
Name:DOERHOFF, ALAN ROY (M D)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROY
Last Name:DOERHOFF
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 SHEPHERD HILLS RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-9478
Mailing Address - Country:US
Mailing Address - Phone:573-230-5444
Mailing Address - Fax:
Practice Address - Street 1:4606 SHEPHERD HILLS RD
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-9478
Practice Address - Country:US
Practice Address - Phone:573-230-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO32394208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery