NPI 1376508788 · live from the CMS NPI Registry
Dothan Pediatric Clinic, P. A.
Pediatrics in Dothan, AL. National Provider Identifier 1376508788, active.
NPI record
| NPI | 1376508788 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics 208000000X |
| Practice location | 126 Clinic Dr, Dothan, AL 36303 |
| Practice phone | 334-793-1881 |
| Enumerated | April 19, 2006 |
| Last updated | July 22, 2021 |
| Authorized official | Gina Tolar, Insurance & Collection Supervisor |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical | 103TC0700X | — |
| Pediatrics, Pediatric Gastroenterology | 2080P0206X | — |
| Nurse Practitioner, Family | 363LF0000X | — |
| Nurse Practitioner, Pediatrics | 363LP0200X | — |
| Pediatrics primary | 208000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.