Individual
JOHN S DORNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
425 HOSPITAL DR, SUITE 4, COLUMBUS, MS 39705-1901
(662) 240-0650
(662) 240-0483
Mailing address
PO BOX 8489, COLUMBUS, MS 39705-0034
(662) 240-0650
(662) 240-0483
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R853422
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00118261
—
MS
Enumeration date
12/20/2006
Last updated
07/08/2007
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