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General NPI Number Information
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NPI Number | 1114021409
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Entity Type | Organization
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Legal Business Name | OBSTETRICS & GYNECOLOGY OF DOTHAN INC
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 104 MEDICAL DR
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City | DOTHAN
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State | AL
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Zip | 36303
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Country | US
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Telephone | 334-671-9445
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Fax | 334-836-0059
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Provider Business Mailing Address
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Address Line | 104 MEDICAL DR
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City | DOTHAN
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State | AL
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Zip | 36303
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Country | US
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Telephone | 334-671-9445
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Fax | 334-836-0059
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | DANA GAYLORD
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Credential |
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Telephone | 334-671-9445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 23245
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DO1161
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 31759
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 31756
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 32437
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License Number State | AL
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA-204
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License Number State | AL
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Taxonomy #7
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 1006758
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License Number State | AL
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Taxonomy #8
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | AL
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Taxonomy #9
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 26014
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License Number State | AL
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