Malcolm P. Dulock, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

013265 Issued in GA

Legal business name

MALCOLM P. DULOCK, MD

Practice address

319 Canton Rd
Cumming, GA 30040-2213

Phone

(678) 456-8200

Fax

(678) 456-8201

NPI assigned

Jun 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Patti Herrick

Title

Business Manager

Phone

(678) 456-8200

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17714/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354579200000",
    "number": "1316141302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402213",
            "telephone_number": "678-456-8200",
            "fax_number": "678-456-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402213",
            "telephone_number": "678-456-8200",
            "fax_number": "678-456-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALCOLM P. DULOCK, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2012-12-04",
        "status": "A",
        "authorized_official_last_name": "HERRICK",
        "authorized_official_first_name": "PATTI",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "678-456-8200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "013265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GRP7624",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1922198647",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Cumming, GA
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.