MEDICARE: JAMES DONOVAN DOROUGH

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
1	106S00000X	Behavior Technician	RBT-25-479984	IN

General Provider Information

NPI Number	:	1154289783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DONOVAN DOROUGH

Provider Business Mailing Address
First Line	:	980 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-2317
Country	:	US
Telephone Number	:	765-229-2870
Fax Number	:

Provider Business Practice Location Address
First Line	:	980 CHESTER BLVD
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-2317
Country	:	US
Telephone Number	:	765-229-2870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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Directions to “ JAMES DONOVAN DOROUGH ” Practice Location

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