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General NPI Number Information
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NPI Number | 1053222513
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Entity Type | Individual
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Provider Name | LUKE AARON DORTON
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Gender | Male
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 130 W RAVINE RD
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City | KINGSPORT
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State | TN
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Zip | 37660-3837
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Country | US
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Telephone | 423-390-0451
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Fax |
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Provider Business Mailing Address
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Address Line | 514 DEERFIELD CIR
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City | CHURCH HILL
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State | TN
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Zip | 37642-3420
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 248341
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License Number State | TN
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