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Individual

DONTRE M DOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
39 KENT RD STE 2, TIFTON, GA 31794-1697
(229) 353-4368
Mailing address
PO BOX 2650, TIFTON, GA 31793-2650

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
104748
GA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
104748
GA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
30873
MN
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
69872
MN

Other

Enumeration date
03/25/2020
Last updated
03/25/2026
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