Provider Demographics
NPI:1033232624
Name:DOXSEY, CORLISS T (MED)
Entity Type:Individual
Prefix:MRS
First Name:CORLISS
Middle Name:T
Last Name:DOXSEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45011-3532
Mailing Address - Country:US
Mailing Address - Phone:513-863-6129
Mailing Address - Fax:
Practice Address - Street 1:140 N 5TH ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-3532
Practice Address - Country:US
Practice Address - Phone:513-863-6129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health