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Individual
BRIAN DOGGETT
Active
Individual
BRIAN DOGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030617A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189506
ANTHEM PROVIDER NUMBER
IN
05
—
100117210
—
IN
01
—
11484429
CAQH NUMBER
IN
01
—
9396981
PHCS PID NUMBER
IN
05
—
DO25507008
—
IN
Enumeration date
03/20/2006
Last updated
07/23/2012
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