Healthcare Provider Details

I. General information

NPI: 1962595694
Provider Name (Legal Business Name): JOHN MCLEMORE DOZIER II CP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VETERANS AVE 121 BUILDING 54
BILOXI MI
39531
US

IV. Provider business mailing address

107 SEA PINE LANE
LONG BEACH MS
39560
US

V. Phone/Fax

Practice location:
  • Phone: 228-523-4583
  • Fax: 228-523-5219
Mailing address:
  • Phone: 205-746-2874
  • Fax: 228-523-5219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number12
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: