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General NPI Number Information
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NPI Number | 1417964149
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Entity Type | Individual
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Provider Name | JOHN THOMAS DORSEY III MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 40 MEDICAL PARK SUITE 502
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City | WHEELING
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State | WV
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Zip | 26003-6392
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Country | US
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Telephone | 304-243-0774
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Fax | 304-243-0776
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Provider Business Mailing Address
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Address Line | 40 MEDICAL PARK SUITE 502
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City | WHEELING
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State | WV
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Zip | 26003-6392
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Country | US
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Telephone | 304-243-0774
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Fax | 304-243-0776
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 14956
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35060754
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License Number State | OH
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