Basic Information
| Provider Information | |||||||||
| NPI: | 1801397468 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOCKERY | ||||||||
| FirstName: | AMRIT | ||||||||
| MiddleName: | KAUR | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2501 W 12TH ST STE C4 | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165054527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144616626 | ||||||||
| FaxNumber: | 8148716351 | ||||||||
| Practice Location | |||||||||
| Address1: | 2501 W 12TH ST STE C4 | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165054527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144616626 | ||||||||
| FaxNumber: | 8148716351 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2018 | ||||||||
| LastUpdateDate: | 11/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS021553 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.