Provider Demographics
NPI:1598786865
Name:DOCKINS, NORMAN LEE (DMSC, PA-C)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:LEE
Last Name:DOCKINS
Suffix:
Gender:M
Credentials:DMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4273
Mailing Address - Country:US
Mailing Address - Phone:970-240-6136
Mailing Address - Fax:
Practice Address - Street 1:300 S NEVADA AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4273
Practice Address - Country:US
Practice Address - Phone:702-497-7519
Practice Address - Fax:970-249-5029
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3370363AM0700X
COPA.0004519363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP64991Medicare UPIN
CO482673ZPR5Medicare PIN