Provider Demographics
NPI:1881654978
Name:DOSS, JOHN RICHARD (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RICHARD
Last Name:DOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 TEXAS BLVD STE 501
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-5117
Mailing Address - Country:US
Mailing Address - Phone:903-794-0888
Mailing Address - Fax:903-794-0894
Practice Address - Street 1:1002 TEXAS BLVD STE 501
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-5117
Practice Address - Country:US
Practice Address - Phone:903-794-0888
Practice Address - Fax:903-794-0894
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4588207V00000X
TXN8644207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145846001Medicaid
AR5M013OtherARK BLUECROSS
TX281034301Medicaid
ARE15121Medicare UPIN
TXTXB125932Medicare Oscar/Certification