Provider Demographics
NPI:1740230929
Name:DORSCHER, JOCELYN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOCELYN
Middle Name:A
Last Name:DORSCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4884 MILLER TRUNK HWY
Mailing Address - Street 2:
Mailing Address - City:HERMANTOWN
Mailing Address - State:MN
Mailing Address - Zip Code:55811-1504
Mailing Address - Country:US
Mailing Address - Phone:218-249-5700
Mailing Address - Fax:
Practice Address - Street 1:4884 MILLER TRUNK HWY
Practice Address - Street 2:
Practice Address - City:HERMANTOWN
Practice Address - State:MN
Practice Address - Zip Code:55811-1504
Practice Address - Country:US
Practice Address - Phone:218-249-5700
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN37966207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNG07886Medicare UPIN