Individual
KYLE D. DORKOSKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
27 ST LAWRENCE DR STE 204, TIFFIN, OH 44883-8312
(419) 455-8570
(419) 455-8579
Mailing address
27 ST LAWRENCE DR STE 204, TIFFIN, OH 44883-8312
(419) 455-8570
(419) 455-8579
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01481
WV
363A00000X
Physician Assistant
Primary
50003728
OH
363AM0700X
Medical Physician Assistant
01481
WV
Other
Enumeration date
10/02/2006
Last updated
12/16/2020
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