Provider Demographics
NPI:1225037641
Name:DOTSON, RONALD LEE (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:LEE
Last Name:DOTSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E HIGHWAY 67
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-4157
Mailing Address - Country:US
Mailing Address - Phone:972-298-8880
Mailing Address - Fax:972-709-9345
Practice Address - Street 1:420 E HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-4157
Practice Address - Country:US
Practice Address - Phone:972-298-8880
Practice Address - Fax:972-709-9345
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1081207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035031601Medicaid
TX035031601Medicaid
TX00N50HMedicare Oscar/Certification
TX752658573OtherTAX ID NUMBER