Provider Demographics
NPI:1609308006
Name:DOSS, DYLAN (DO)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:DOSS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16857 E SAGUARO BLVD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-6616
Mailing Address - Country:US
Mailing Address - Phone:480-626-9578
Mailing Address - Fax:920-241-1167
Practice Address - Street 1:16857 E SAGUARO BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6616
Practice Address - Country:US
Practice Address - Phone:480-626-9578
Practice Address - Fax:920-241-1167
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008350207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine