Provider Demographics
NPI:1093103608
Name:DORSEY, KAMAL
Entity Type:Individual
Prefix:
First Name:KAMAL
Middle Name:
Last Name:DORSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42367 DELUXE PLZ
Mailing Address - Street 2:SUITE 30
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1243
Mailing Address - Country:US
Mailing Address - Phone:985-265-2161
Mailing Address - Fax:
Practice Address - Street 1:42367 DELUXE PLZ
Practice Address - Street 2:SUITE 30
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1243
Practice Address - Country:US
Practice Address - Phone:504-234-2432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator