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NPI Code Detail

MEDICARE: PATRICK MARTIN DOGGETT MD

MEDICARE: PATRICK MARTIN DOGGETT MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD453813PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124384573
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK MARTIN DOGGETT MD
Provider Business Mailing Address
First Line : 2144 CECIL B MOORE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19121-4014
Country : US
Telephone Number : 215-320-6187
Fax Number : 215-236-2308
Provider Business Practice Location Address
First Line : 2144 CECIL B MOORE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19121-4014
Country : US
Telephone Number : 215-320-6187
Fax Number : 215-236-2308
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2012
Last Update Date : 12/09/2016

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