Individual
JILL M DORSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
807 CHILDRENS WAY, NEMOURS CHILDRENS CLINIC, JACKSONVILLE, JACKSONVILLE, FL 32207-8426
(904) 697-3694
(904) 697-3927
Mailing address
P.O. BOX 5720, PROVIDER ENROLLMENT DEPARTMENT, JACKSONVILLE, FL 32247-5720
(302) 651-6201
(407) 650-7578
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
57009706
OH
2080P0206X
Pediatric Gastroenterology Physician
Primary
ME102416
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000478600
—
FL
Enumeration date
05/17/2007
Last updated
10/21/2011
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