Basic Information
Provider Information
NPI: 1326285347
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOSS
FirstName: DENNIS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 40 S MAIN ST STE 1300
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381035513
CountryCode: US
TelephoneNumber: 8669490108
FaxNumber:  
Practice Location
Address1: 420 20TH ST N STE 2200
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352033261
CountryCode: US
TelephoneNumber: 8669490108
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/13/2009
LastUpdateDate: 08/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X1-093182ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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