Provider Demographics
NPI:1376717983
Name:DOCTORS GROUP, INC.
Entity Type:Organization
Organization Name:DOCTORS GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:TAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-512-9862
Mailing Address - Street 1:6894 LAKE WORTH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2964
Mailing Address - Country:US
Mailing Address - Phone:561-512-9862
Mailing Address - Fax:
Practice Address - Street 1:6894 LAKE WORTH RD STE 104
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2964
Practice Address - Country:US
Practice Address - Phone:561-512-9862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty