Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 19684 | MS |
N | 208600000X | Surgeon | 19684 | MS |
Y | 2086S0105X | Surgery of the Hand | 44495 | TN |
NPI | 1952426074 |
---|---|
Provider Name | Dr. Michael Sean Dolan |
First Address | Jackson, TN 38305-2070 |
Second Address | Jackson, TN 38305-2070 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 02/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1514547 | (05) | TN |