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Individual

MARK E DOROGY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
612 W GORDON ST, SUITE C, THOMASTON, GA 30286-3480
(706) 646-5712
(706) 647-5111
Mailing address
612 W GORDON ST, SUITE C, THOMASTON, GA 30286-3480
(706) 646-5712
(706) 647-5111

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
041105
GA
207RI0011X
Interventional Cardiology Physician
041105
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000692755A
GA
Enumeration date
06/15/2006
Last updated
08/24/2016
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