DOTHAN ANESTHESIOLOGY ASSOCIATES PC - NPI NUMBER 1013997857

Summary

Provider Name: DOTHAN ANESTHESIOLOGY ASSOCIATES PC

NPI Number: 1013997857

Clasification: Anesthesiology (207LP2900X)

Specialization: Pain Medicine

Address:
4370 W MAIN ST
ANESTHESIA DEPT
DOTHAN, AL
ZIP 36305

Phone Number: (334) 794-5000



Detailed Information

DOTHAN ANESTHESIOLOGY ASSOCIATES PC is a pain medicine anesthesiologist in Dothan, AL. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. The assigned NPI number for this provider is 1013997857 and is registered as an organization entity type and is a multi-specialty group.

The provider's business address is:

4370 W MAIN ST
ANESTHESIA DEPT
DOTHAN, AL
ZIP 36305-056
Phone: (334) 794-5000

The provider's authorized official is Kenneth C Fletcher .
The authorized official title is President and has the following contact phone number (334) 794-5000.

The enumeration date for this NPI number is 1/18/2006 and was last updated on 4/20/2008.

Map - Location of Practice

Similar Providers

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1033199237 DR. STEPHEN L HUGHES, MD
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1033198122 KYLE MORRIS JONES, M.D.
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1083684294 DR. JEREMY BERNARD SMITH, M.D.
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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207LP2900X Anesthesiology Pain Medicine ========= AL No
2 207L00000X Anesthesiology ========= AL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 E85399 MEDICARE PIN AL

NPI Record

No. Field Name Field Value
1 NPI 1013997857
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name DOTHAN ANESTHESIOLOGY ASSOCIATES PC
5 Provider First Line Business Practice Location Address 4370 W MAIN ST
6 Provider Second Line Business Practice Location Address ANESTHESIA DEPT
7 Provider Business Practice Location Address City Name DOTHAN
8 Provider Business Practice Location Address State Name AL
9 Provider Business Practice Location Address Postal Code 363051056
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 3347945000
12 Provider Enumeration Date 1/18/2006
13 Last Update Date 4/20/2008
14 Authorized Official Last Name FLETCHER
15 Authorized Official First Name KENNETH
16 Authorized Official Middle Name C
17 Authorized Official Title or Position PRESIDENT
18 Authorized Official Telephone Number 3347945000
19 Healthcare Provider Taxonomy Code 1 207LP2900X
20 Provider License Number 1 =========
21 Provider License Number State Code 1 AL
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 207L00000X
24 Provider License Number 2 =========
25 Provider License Number State Code 2 AL
26 Healthcare Provider Primary Taxonomy Switch 2 Y
27 Other Provider Identifier 1 E85399
28 Other Provider Identifier Type Code 1 08
29 Other Provider Identifier State 1 AL
30 Is Organization Subpart N
31 Authorized Official Credential Text MD
32 Healthcare Provider Taxonomy Group 1 193200000X MULTI-SPECIALTY GROUP
33 Healthcare Provider Taxonomy Group 2 193200000X MULTI-SPECIALTY GROUP

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.