Provider Demographics
NPI:1538344072
Name:DORIOTT, ELIZABETH ANNE (DO)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:DORIOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11465 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3525
Mailing Address - Country:US
Mailing Address - Phone:513-671-2555
Mailing Address - Fax:513-671-0135
Practice Address - Street 1:11465 SPRINGFIELD PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-3525
Practice Address - Country:US
Practice Address - Phone:513-671-2555
Practice Address - Fax:513-671-0135
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-006593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0055351Medicaid
OHP01193208Medicare PIN
OHH0035021Medicare PIN
OH0055351Medicaid