Provider Demographics
NPI:1366602690
Name:DORSEY, JESSICA SCRUGGS (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:SCRUGGS
Last Name:DORSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 MEDICAL PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2776
Mailing Address - Country:US
Mailing Address - Phone:512-260-5860
Mailing Address - Fax:512-260-5859
Practice Address - Street 1:1515 MEDICAL PKWY STE 100
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2776
Practice Address - Country:US
Practice Address - Phone:512-260-5860
Practice Address - Fax:512-260-5859
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0435749207N00000X
MO2012006736207N00000X
TXP3578207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatology