Provider Demographics
NPI:1730434689
Name:DOTY, DALLAS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:DALLAS
Middle Name:
Last Name:DOTY
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 S THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-6329
Mailing Address - Country:US
Mailing Address - Phone:479-927-1568
Mailing Address - Fax:
Practice Address - Street 1:2001 S THOMPSON ST
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-6329
Practice Address - Country:US
Practice Address - Phone:479-927-1568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist