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General NPI Number Information
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NPI Number | 1003000308
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Entity Type | Organization
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Legal Business Name | KEITH M DOCKERY, MD PC
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 1800 PEACHTREE ST NW SUITE 700
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City | ATLANTA
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State | GA
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Zip | 30309-2519
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Country | US
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Telephone | 404-350-7966
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Fax | 404-350-7968
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Provider Business Mailing Address
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Address Line | 1800 PEACHTREE ST NW SUITE 700
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City | ATLANTA
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State | GA
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Zip | 30309-2519
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Country | US
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Telephone | 404-350-7966
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Fax | 404-350-7968
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MS. MELISSA PARKS DILL
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Credential |
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Telephone | 404-350-7966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD003711
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License Number State | GA
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