Provider Demographics
NPI:1497993992
Name:DOLNEY, ROGER GORDON
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:GORDON
Last Name:DOLNEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 JIMMY CARTER PL
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-6281
Mailing Address - Country:US
Mailing Address - Phone:507-474-1509
Mailing Address - Fax:
Practice Address - Street 1:707 JIMMY CARTER PL
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987-6281
Practice Address - Country:US
Practice Address - Phone:507-474-1509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health