Provider Demographics
NPI:1174731186
Name:DONOFRIO, LORENA KAY (DO)
Entity type:Individual
Prefix:
First Name:LORENA
Middle Name:KAY
Last Name:DONOFRIO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5450 FRANTZ RD STE 360
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-4141
Mailing Address - Country:US
Mailing Address - Phone:614-544-6155
Mailing Address - Fax:614-544-6370
Practice Address - Street 1:24 W GREEN DR STE 246
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-2974
Practice Address - Country:US
Practice Address - Phone:740-592-7020
Practice Address - Fax:740-592-7021
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34.009128207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2943506Medicaid
OH2943506Medicaid