Healthcare Provider Details
I. General information
NPI: 1740997675
Provider Name (Legal Business Name): DOT MEDICAL EXAMS 4 U LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/31/2022
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
956 KILLIAN HILL RD SW STE B
LILBURN GA
30047-8977
US
IV. Provider business mailing address
956 KILLIAN HILL RD SW STE B
LILBURN GA
30047-8977
US
V. Phone/Fax
- Phone: 770-335-2434
- Fax:
- Phone: 770-335-2434
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QI0500X |
| Taxonomy | Infusion Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHEROCKO
RIESHELL
GATLING-JAMES
Title or Position: BUSINESS OWNER
Credential:
Phone: 770-807-4710