Provider Demographics
NPI:1326696410
Name:DOSS, LETTIE J
Entity Type:Individual
Prefix:
First Name:LETTIE
Middle Name:J
Last Name:DOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 ROBINSON COLEMAN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39082-4138
Mailing Address - Country:US
Mailing Address - Phone:601-219-7606
Mailing Address - Fax:601-858-2531
Practice Address - Street 1:123 ROBINSON COLEMAN RD
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MS
Practice Address - Zip Code:39082-4138
Practice Address - Country:US
Practice Address - Phone:601-219-7606
Practice Address - Fax:601-858-2531
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-31
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider