MEDICARE: DR. JOHN ROBERT DORSCH D.O.

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
1	2083A0100X	Aerospace Medicine Physician	02002516A	IN
2	2084P0800X	Psychiatry Physician	201100786	NC
3	207P00000X	Emergency Medicine Physician	2011-00786	NC

General Provider Information

NPI Number	:	1629058821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ROBERT DORSCH D.O.

Provider Business Mailing Address
First Line	:	1434 BAREBACK TRL
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434-5618
Country	:	US
Telephone Number	:	937-912-9113
Fax Number	:

Provider Business Practice Location Address
First Line	:	4881 SUGAR MAPLE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45433-5529
Country	:	US
Telephone Number	:	937-257-0855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	02/27/2025

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