Healthcare Provider Details
I. General information
NPI: 1487652111
Provider Name (Legal Business Name): ARTHUR J DORRINGTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/07/2005
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4855 S MOORLAND RD SUITE 150
NEW BERLIN WI
53151-7401
US
IV. Provider business mailing address
4855 S MOORLAND RD SUITE 150
NEW BERLIN WI
53151-7401
US
V. Phone/Fax
- Phone: 414-425-5660
- Fax: 414-425-9803
- Phone: 414-425-5660
- Fax: 414-425-9803
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 18493 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: