Individual
MR. MICHAEL RUSSELL DORMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
5825 AIRLINE HWY, BATON ROUGE, LA 70805-2408
(225) 358-3920
(225) 358-1158
Mailing address
15442 CAMPANILE CT, BATON ROUGE, LA 70810-0309
(225) 358-3920
(225) 358-1158
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14481
LA
Other
Enumeration date
08/15/2005
Last updated
07/08/2007
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