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DOTHAN INTERNAL MEDICINE LLC NPI 1962890178


NPI Information

NPI: 1962890178
Provider Name: DOTHAN INTERNAL MEDICINE, LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1118 ROSS CLARK CIR
SUITE 105
DOTHAN, AL
ZIP 36301
Phone: (334) 699-2004
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DOTHAN INTERNAL MEDICINE, LLC is a specialist in Dothan, AL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DOTHAN INTERNAL MEDICINE, LLC NPI is 1962890178. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1118 ROSS CLARK CIR
SUITE 105
DOTHAN, AL
ZIP 36301-001
Phone: (334) 699-2004
Fax: (334) 699-2006

The provider's authorized official is Rodney K Beuachamp .
The authorized official title is Owner and has the following contact phone number (334) 699-2004.

The enumeration date for this NPI number is 12/23/2014 and was last updated on 12/23/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist20759ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11003831983OTHERALABAMANPI INDIVIDUAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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