Provider Demographics
NPI:1346476298
Name:DOTSON, CAMI LOCKHART (REGISTEREED FITTER-M)
Entity Type:Individual
Prefix:MRS
First Name:CAMI
Middle Name:LOCKHART
Last Name:DOTSON
Suffix:
Gender:F
Credentials:REGISTEREED FITTER-M
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 39
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:NC
Mailing Address - Zip Code:28750-0039
Mailing Address - Country:US
Mailing Address - Phone:828-894-5700
Mailing Address - Fax:828-894-5772
Practice Address - Street 1:133 SHUFORD ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722
Practice Address - Country:US
Practice Address - Phone:828-894-5700
Practice Address - Fax:828-894-5772
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DERFM00958225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795270Medicaid