Provider Demographics
NPI:1427035310
Name:DOTSON, CHRISTOPHER J (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:DOTSON
Suffix:
Gender:M
Credentials:DPT
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 312
Mailing Address - Street 2:
Mailing Address - City:WEBSTER SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:26288-0312
Mailing Address - Country:US
Mailing Address - Phone:304-847-5682
Mailing Address - Fax:304-847-5985
Practice Address - Street 1:324 MILLER MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-1026
Practice Address - Country:US
Practice Address - Phone:304-847-5682
Practice Address - Fax:304-847-5985
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001923225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0810004000Medicaid
WVW36409Medicare UPIN
DO7261521Medicare ID - Type Unspecified