Provider Demographics
NPI:1548398761
Name:WILLIAM R DORSEY D O INC
Entity type:Organization
Organization Name:WILLIAM R DORSEY D O INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGERS
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-291-3118
Mailing Address - Street 1:2591 MIAMISBURG CENTERVILLE RD
Mailing Address - Street 2:STE 301
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-3711
Mailing Address - Country:US
Mailing Address - Phone:937-439-5252
Mailing Address - Fax:937-439-9242
Practice Address - Street 1:2591 MIAMISBURG CENTERVILLE RD
Practice Address - Street 2:STE 301
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3711
Practice Address - Country:US
Practice Address - Phone:937-291-3118
Practice Address - Fax:937-439-9242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2150970Medicaid
OH9305911Medicare PIN