Individual
MATTHEW CARLTON DORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, SUITE 101, ABINGDON, VA 24211-7664
(276) 258-1777
(276) 258-1778
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0102203056
VA
208600000X
Surgery Physician
34.0095-07
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649477209
—
VA
01
—
P01128299
RAILROAD MEDICARE
VA
Enumeration date
06/28/2007
Last updated
08/20/2024
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