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NPI Code Detail

MEDICARE: DR. JOHN RICHARD DORRIS III MD

MEDICARE:  DR. JOHN RICHARD DORRIS III MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician40899GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
110578123OTHERGACAQH

General Provider Information

NPI Number : 1104807429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN RICHARD DORRIS III MD
Provider Business Mailing Address
First Line : 1765 OLD WEST BROAD ST BLDG 2-200
Second Line :
City : ATHENS
State : GA
Zip : 30606-2887
Country : US
Telephone Number : 706-549-1663
Fax Number : 706-546-8792
Provider Business Practice Location Address
First Line : 1765 OLD WEST BROAD ST
Second Line :
City : ATHENS
State : GA
Zip : 30606-2853
Country : US
Telephone Number : 706-549-1663
Fax Number : 706-546-8792
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2005
Last Update Date : 07/01/2025

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Directions to “ DR. JOHN RICHARD DORRIS III MD” Practice Location

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