Individual provider Active NPI

Hector M. Dourron, M.D.

  • Vascular Surgery Physician
  • Dalton, GA
National Provider Identifier
1366435182
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
052556 Issued in GA
Practice address
1109 Burleyson Rd Ste 202
Dalton, GA 30720-3094
Phone
(706) 259-3336
Fax
(706) 370-7715
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 052556 GA Primary
Specialist 174400000X 54489 GA

Addresses

Primary practice location

1109 Burleyson Rd Ste 202
Dalton, GA 30720-3094

Mailing address

1109 Burleyson Rd Ste 202
Dalton, GA 30720-3094
Phone (706) 259-3336

Other identifiers 1

IdentifierTypeStateIssuer
080040114AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917000437 GA Practitioner - Vascular SurgeryPractitioner - Infectious Disease 9739157801 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Medical Center, IncGroup PAC ID 0446151179, 105 clinicians

Practice addresses (Care Compare)

1200 Memorial Dr
Dalton, GA 30720-2529
Phone (706) 272-6000

Hospital & facility affiliations

  • Hamilton Medical Center Hospital, Dalton, GA, CCN 110001

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)29
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54489GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennestone Hospital, Inc CurrentSince Jun 1, 2011 Accepting new patients
Kennestone Hospital, Inc. CurrentSince Jun 1, 2011 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Sep 25, 2017 Accepting new patients
Hamilton Physician Group Inc CurrentSince Sep 25, 2017 Accepting new patients
Northside Surgical Professional Services LLC CurrentSince Jun 1, 2017 Accepting new patients
Cobb Hospital, Inc Past Accepting new patients
Quantum Radiology, PC Past Accepting new patients

Locations

460 Northside Cherokee Blvd
Ste 100
Canton, GA 30115
Phone (770) 292-3490

1109 Burleyson Rd
Ste 202
Dalton, GA 30720
Phone (706) 259-3336

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

980 Johnson Fy Rd NE
Ste 1040
Sandy Springs, GA 30342
Phone (404) 843-2721

Interoperability endpoints

  • Direct secure messaging: hdourron18827@hhcs.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1366435182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 BURLEYSON RD STE 202",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203094",
            "telephone_number": "706-259-3336",
            "fax_number": "706-370-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 BURLEYSON RD STE 202",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203094",
            "telephone_number": "706-259-3336",
            "fax_number": "706-370-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOURRON",
        "first_name": "HECTOR",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GA",
            "license": "052556",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "54489",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080040114A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.