Individual
LORI JEAN DOTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
965 S BAILEY AVE, SOUTH HAVEN, MI 49090-6743
(269) 639-2833
(269) 639-2776
Mailing address
965 S BAILEY AVE, SOUTH HAVEN, MI 49090-6743
(269) 639-2833
(269) 639-2776
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301074647
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417961137
BCBSM - BRONSON VICKSBURG OUTPATIENT CENTER
MI
05
—
1639198179
—
MI
05
—
4100004 T10
—
MI
05
—
4574494
—
MI
Enumeration date
07/18/2006
Last updated
11/22/2016
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