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OBSTETRICS GYNECOLOGY OF DOTHAN INC
Obstetrics & Gynecology

NPI Profile for OBSTETRICS GYNECOLOGY OF DOTHAN INC in DOTHAN, AL.

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Contact Information

OBSTETRICS & GYNECOLOGY OF DOTHAN INC
104 MEDICAL DR
DOTHAN, AL  36303
 Phone: 334-671-9445
 Fax: 334-836-0059
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Obstetrics & Gynecology

 207V00000X 16 Physician/Obstetrics & Gynecology
 

Obstetrics & Gynecology

 363LX0001X 50 Nurse Practitioner
 

Physician Assistant

 363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for OBSTETRICS GYNECOLOGY OF DOTHAN INC · (Female)

NPI Number 1114021409
Status Active
Credentials
Entity Individual
Enumeration date 09/08/2006
Last updated 12/04/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • AL License # 1006758
  • AL License # 23245
  • AL License # 26014
  • AL License # 31756
  • AL License # 31759
  • AL License # 32437
  • AL License # DO1161
  • AL License # PA-204
  • AL Medicaid 051502953
  • AL Medicaid 051520983
  • Other 01D0989955 CLIA WAIVED
  • Other 01D2074304 CLIA WAIVED
  • Other 01D2068157 CLIA WAVIER
  • Other 529928670 MEDICAID GROUP
  • Other C47766 MEDICAL PROTECTIVE
  • Other 1826 MEDICARE GROUP NUMBER
  • AL Other 01D2043043 CLIA WAIVED
  • AL Other 01D2052896 CLIA WAIVED
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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