Basic Information
| Provider Information | |||||||||
| NPI: | 1629131503 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LANCE C. DOZIER | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1205 | ||||||||
| Address2: | |||||||||
| City: | NORTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242730912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766790800 | ||||||||
| FaxNumber: | 2766791261 | ||||||||
| Practice Location | |||||||||
| Address1: | 338 COEBURN AVE SW | ||||||||
| Address2: | |||||||||
| City: | NORTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242732606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2766790800 | ||||||||
| FaxNumber: | 2766791261 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2006 | ||||||||
| LastUpdateDate: | 05/26/2015 | ||||||||
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| AuthorizedOfficialLastName: | DOZIER | ||||||||
| AuthorizedOfficialFirstName: | LANCE | ||||||||
| AuthorizedOfficialMiddleName: | CARY | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2766790800 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 0101035554 | VA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 010160456 | 05 | VA | MEDICAID | 176979 | 01 | VA | ANTHEM BCBS | OTHER | 64230584 | 01 | KY | KY MEDICAID | OTHER |