Provider Demographics
NPI:1952679870
Name:RONALD L DOTSON MD PA
Entity Type:Organization
Organization Name:RONALD L DOTSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-298-8880
Mailing Address - Street 1:420 E HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-4157
Mailing Address - Country:US
Mailing Address - Phone:972-298-8880
Mailing Address - Fax:972-709-9345
Practice Address - Street 1:420 E HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-4157
Practice Address - Country:US
Practice Address - Phone:972-298-8880
Practice Address - Fax:972-709-9345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1081207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1225037641OtherINDIVIDUAL NPI
TX035031601Medicaid
TX035031601Medicaid
TX00N50HMedicare Oscar/Certification