Provider Demographics
NPI:1245223890
Name:DOSS, ROY E (OD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:E
Last Name:DOSS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:1115 SOUTH ELM STREET
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-0007
Mailing Address - Country:US
Mailing Address - Phone:706-335-5139
Mailing Address - Fax:706-335-9363
Practice Address - Street 1:1115 S ELM ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:GA
Practice Address - Zip Code:30529-2843
Practice Address - Country:US
Practice Address - Phone:706-335-5139
Practice Address - Fax:706-335-9363
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1689152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1245223890OtherDR.ROY E. DOSS NPI #
GA00810389AMedicaid
GA1174693410OtherGROUP NPI NUMBER
GAGA1689OtherSTATE LICENSE #
GA1245223890OtherDR.ROY E. DOSS NPI #
GAGRP3421Medicare PIN
GA1174693410OtherGROUP NPI NUMBER
GAGA1689OtherSTATE LICENSE #
GA1284520001Medicare NSC