Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT3848 | AL |
NPI | 1033165113 |
---|---|
Provider Name | Lonnie Blake Dorcey |
First Address | Birmingham, AL 35203-1628 |
Second Address | Birmingham, AL 35203-1628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 29/03/2018 |