Provider Demographics
NPI:1952473639
Name:DORSEY SURGICAL ASSOCIATES,P.A
Entity Type:Organization
Organization Name:DORSEY SURGICAL ASSOCIATES,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SURGERY
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD,FACS
Authorized Official - Phone:620-342-5500
Mailing Address - Street 1:1301 W 12TH AVE
Mailing Address - Street 2:SUITE 301B
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-2587
Mailing Address - Country:US
Mailing Address - Phone:620-342-5500
Mailing Address - Fax:620-342-5556
Practice Address - Street 1:1301 W 12TH AVE
Practice Address - Street 2:SUITE 301B
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-2587
Practice Address - Country:US
Practice Address - Phone:620-342-5500
Practice Address - Fax:620-342-5556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427375208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100281020DMedicaid
KS111002Medicare ID - Type Unspecified
KSE66705Medicare UPIN