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General NPI Number Information
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NPI Number | 1295915320
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Entity Type | Organization
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Legal Business Name | DR MIKE DORCIK, PA
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 12511 MCCULLY DR
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City | BILOXI
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State | MS
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Zip | 39532-9091
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Country | US
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Telephone | 419-602-1451
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Fax |
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Provider Business Mailing Address
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Address Line | 12511 MCCULLY DR
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City | BILOXI
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State | MS
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Zip | 39532-9091
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Country | US
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Telephone | 419-602-1451
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL DORCIK
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Credential | DO
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Telephone | 419-602-1451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 14179
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 14179
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34.006377
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License Number State | OH
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