MEDICARE: DR. JOEY SASSER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	208D00000X	General Practice Physician	2640	AL

General Provider Information

NPI Number	:	1184249880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEY SASSER DO

Provider Business Mailing Address
First Line	:	3144 ROSS CLARK CIR
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-3038
Country	:	US
Telephone Number	:	334-791-3355
Fax Number	:	334-923-4264

Provider Business Practice Location Address
First Line	:	3144 ROSS CLARK CIR
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-3038
Country	:	US
Telephone Number	:	334-791-3355
Fax Number	:	334-923-4264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	01/20/2025

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