Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 067910 | GA |
N | 208000000X | Pediatrician | 067910 | GA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 067910 | GA |
NPI | 1184801714 |
---|---|
Provider Name | Jean Dozier |
First Address | Macon, GA 31201-2102 |
Second Address | Macon, GA 31201-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2008 |
Last Update Date | 30/03/2021 |