Individual
DR. JAMES ENOCH DOPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1918 NORTHLAKE PKWY, SUITE 101, TUCKER, GA 30084-7070
(770) 723-9318
(770) 723-0176
Mailing address
1918 NORTHLAKE PKWY, SUITE 101, TUCKER, GA 30084-7070
(770) 723-9318
(770) 723-0176
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31587
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000040724
MEDICAID REF#
GA
05
—
00412475A
—
GA
01
—
31587
STATE LICENSE
GA
01
—
720953488
TAX ID
GA
Enumeration date
09/20/2006
Last updated
03/07/2023
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