Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD7525 | TN |
NPI | 1184697898 |
---|---|
Provider Name | Dr. Kenneth C. Dozier |
First Address | Madison, TN 37115-5141 |
Second Address | Madison, TN 37115-5141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2006 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F69393 | (02) |