Healthcare Provider Details

I. General information

NPI: 1154345411
Provider Name (Legal Business Name): ROBERT S DOTSON JR. M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBERT S DOTSON JR. MD

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4134 GAMBLE RD
MONTICELLO FL
32344-6642
US

IV. Provider business mailing address

4134 GAMBLE RD
MONTICELLO FL
32344-6642
US

V. Phone/Fax

Practice location:
  • Phone: 865-607-2014
  • Fax: 850-807-5129
Mailing address:
  • Phone: 865-607-2014
  • Fax: 850-807-5129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME135243
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: