Healthcare Provider Details

I. General information

NPI: 1831864891
Provider Name (Legal Business Name): RAO HEART & VASCULAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 OBRANNAN PARK DR
DOTHAN AL
36303-2052
US

IV. Provider business mailing address

118 OBRANNAN PARK DR
DOTHAN AL
36303-2052
US

V. Phone/Fax

Practice location:
  • Phone: 334-305-2800
  • Fax: 866-554-1248
Mailing address:
  • Phone: 334-305-2800
  • Fax: 866-554-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: PETER M RAO
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 334-305-2800