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General NPI Number Information
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NPI Number | 1215253315
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Entity Type | Organization
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Legal Business Name | DENISE L DORSEY MD A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 04/14/2010
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 1519 FERN ST
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City | NEW ORLEANS
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State | LA
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Zip | 70118-4005
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Country | US
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Telephone | 504-865-1723
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Fax | 504-865-1723
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Provider Business Mailing Address
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Address Line | 1519 FERN ST
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City | NEW ORLEANS
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State | LA
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Zip | 70118-4005
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Country | US
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Telephone | 504-865-1723
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Fax | 504-865-1723
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENISE LYNETTE DORSEY
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Credential | M.D.
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Telephone | 504-865-1723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | MD.013776
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License Number State | LA
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