Individual
DR. JONATHAN M DORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8260 WILLOW OAKS CORPORATE DR STE 600, FAIRFAX, VA 22031-4528
(571) 472-4670
(571) 665-6798
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3300
(703) 776-4001
(703) 776-7113
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101245506
VA
208600000X
Surgery Physician
0427231
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100294940A
—
KS
Enumeration date
07/07/2005
Last updated
11/16/2022
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