Provider Demographics
NPI:1891754230
Name:DOTY, JAMES M (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:DOTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:350 NW 84TH AVE
Mailing Address - Street 2:STE 311
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1817
Mailing Address - Country:US
Mailing Address - Phone:954-476-9899
Mailing Address - Fax:954-476-9180
Practice Address - Street 1:350 NW 84TH AVE
Practice Address - Street 2:STE 311
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1817
Practice Address - Country:US
Practice Address - Phone:954-476-9899
Practice Address - Fax:954-476-9180
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME88638208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269992300Medicaid
FL37801OtherBCBS OF FL
FL269992300Medicaid
FL37801XMedicare PIN
G82611Medicare UPIN