Doty, David Kenneth

Doty, David Kenneth is an individual health care provider with primary practice located at 4706 Woodland Dr E , Tifton GA 31794-2303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Doty, David Kenneth can be contacted via phone (952) 595-1100.

Contact Information

Primary practice address
4706 Woodland Dr E Tifton GA 31794-2303
Phone: (952) 595-1100
Fax: (952) 942-3361
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 049006 Georgia

Profile Details

NPI number 1902899149
LBN Legal business name Doty, David Kenneth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2005
Last updated Apr 19th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902899149 NPPES
Kentucky Other 3323297 MEDICARE 855R
Kentucky Other 91716 MEDICARE 855R
Kentucky MEDICAID 64129620 MEDICARE 855R
Kentucky MEDICAID 00875641A MEDICARE 855R
Kentucky Other 3427936000 MEDICARE 855R
Kentucky MEDICAID 010348293 MEDICARE 855R
Kentucky MEDICAID 102112303 MEDICARE 855R
Kentucky Other 50017681 MEDICARE 855R
Kentucky Other 000000548193 MEDICARE 855R

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