Individual
BRIAN DOGGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
651 ARMORY RD, DELPHI, IN 46923-1910
(765) 448-8000
(765) 564-6580
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01030617A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189506
ANTHEM PROVIDER NUMBER
IN
05
—
100117210
—
IN
01
—
11484429
CAQH NUMBER
IN
01
—
9396981
PHCS PID NUMBER
IN
05
—
DO25507008
—
IN
Enumeration date
03/20/2006
Last updated
07/23/2012
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