Healthcare Provider Details

I. General information

NPI: 1245155779
Provider Name (Legal Business Name): DOTHAN MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1118 ROSS CLARK CIR STE 100
DOTHAN AL
36301-3023
US

IV. Provider business mailing address

1118 ROSS CLARK CIR STE 100
DOTHAN AL
36301-3023
US

V. Phone/Fax

Practice location:
  • Phone: 334-794-1148
  • Fax:
Mailing address:
  • Phone: 334-794-1148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: CINDY O FOLKES
Title or Position: ADMINISTRATOR
Credential:
Phone: 334-794-1148