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NPI Code Detail

MEDICARE: DR. SAMUEL J DOCKSEY DO

MEDICARE: DR. SAMUEL J DOCKSEY DO
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
1207P00000XEmergency Medicine Physician81356WI
2207P00000XEmergency Medicine Physician05-43010KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578091500
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL J DOCKSEY DO
Provider Business Mailing Address
First Line : 650 HUEBNER RD
Second Line :
City : FORT RILEY
State : KS
Zip : 66442-4030
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2900 W OKLAHOMA AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4330
Country : US
Telephone Number : 414-649-7229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2017
Last Update Date : 12/03/2025

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