Healthcare Provider Details

I. General information

NPI: 1902367980
Provider Name (Legal Business Name): SHELBY DOZIER EUBANKS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHELBY FRANCES DOZIER NP-C

II. Dates (important events)

Enumeration Date: 03/30/2019
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 E 3RD AVE
CORDELE GA
31015-3605
US

IV. Provider business mailing address

408 E 3RD AVE
CORDELE GA
31015-3605
US

V. Phone/Fax

Practice location:
  • Phone: 229-271-2229
  • Fax:
Mailing address:
  • Phone: 229-271-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN248977
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: