Provider Demographics
NPI:1033459672
Name:DOTSON, TIFFANY (PA-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:DOTSON
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 HIGHWAY 70 E STE I
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2075
Mailing Address - Country:US
Mailing Address - Phone:423-368-1124
Mailing Address - Fax:
Practice Address - Street 1:113 HIGHWAY 70 E STE I
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2075
Practice Address - Country:US
Practice Address - Phone:615-441-4487
Practice Address - Fax:615-441-4575
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2223363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical