=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952473639
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DORSEY SURGICAL ASSOCIATES,P.A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2006
-----------------------------------------------------
Last Update Date | 11/11/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1301 W 12TH AVE SUITE 301B
-----------------------------------------------------
City | EMPORIA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66801-2587
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-342-5500
-----------------------------------------------------
Fax | 620-342-5556
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1301 W 12TH AVE SUITE 301B
-----------------------------------------------------
City | EMPORIA
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66801-2587
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-342-5500
-----------------------------------------------------
Fax | 620-342-5556
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GENERAL SURGERY
-----------------------------------------------------
Name | DR. ROBERT F DORSEY
-----------------------------------------------------
Credential | M.D.,F.A.C.S.
-----------------------------------------------------
Telephone | 620-342-5500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | 0427375
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------