Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 35.093446 | OH |
N | 208000000X | Pediatrician | LL29212 | SC |
Y | 2080P0204X | Pediatric Emergency Doctor | ME112995 | FL |
NPI | 1144300013 |
---|---|
Provider Name | Dr. Kurtis Wilson Dotson |
First Address | Jacksonville, FL 32207-8210 |
Second Address | Jacksonville, FL 32207-8210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 09/07/2012 |