Provider Demographics
NPI:1710748082
Name:DOTSON, LARKEY R (PA-C)
Entity Type:Individual
Prefix:
First Name:LARKEY
Middle Name:R
Last Name:DOTSON
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:6005 PARK AVE STE 802
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5218
Mailing Address - Country:US
Mailing Address - Phone:901-236-0508
Mailing Address - Fax:901-682-2143
Practice Address - Street 1:6005 PARK AVE STE 802
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5218
Practice Address - Country:US
Practice Address - Phone:901-236-0508
Practice Address - Fax:901-682-2143
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical