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General NPI Number Information
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NPI Number | 1942674189
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Entity Type | Individual
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Provider Name | ZACHARY DOTSON
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Gender | Male
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Dates
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Enumeration Date | 11/28/2015
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Last Update Date | 11/28/2015
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR
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City | FORT CARSON
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State | CO
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Zip | 80913-4613
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Country | US
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Telephone | 720-448-5998
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Fax |
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Provider Business Mailing Address
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Address Line | 7833 BUCKEYE TREE LN
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City | COLORADO SPRINGS
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State | CO
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Zip | 80927-4025
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Country | US
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Telephone | 720-448-5998
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number |
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License Number State |
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