Provider Demographics
NPI:1942201389
Name:DORSON, PETER GEORGE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:GEORGE
Last Name:DORSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-0074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1125 TRENTON-HARBOURTON RD
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08560-0200
Practice Address - Country:US
Practice Address - Phone:800-526-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX303231835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric