Provider Demographics
NPI:1043739592
Name:WARREN DOPSON MD, PC
Entity Type:Organization
Organization Name:WARREN DOPSON MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-736-8006
Mailing Address - Street 1:706 N COLLEGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5824
Mailing Address - Country:US
Mailing Address - Phone:208-736-8006
Mailing Address - Fax:208-736-8007
Practice Address - Street 1:706 N COLLEGE RD STE A
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-5824
Practice Address - Country:US
Practice Address - Phone:208-736-8006
Practice Address - Fax:208-736-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-8903261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center