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General NPI Number Information
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NPI Number | 1174790299
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Entity Type | Individual
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Provider Name | BOBBY STEPHEN SANDERS JR. MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 256 HONEYSUCKLE RD STE 20
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City | DOTHAN
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State | AL
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Zip | 36305-1168
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Country | US
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Telephone | 334-699-3320
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Fax | 334-699-3342
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Provider Business Mailing Address
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Address Line | PO BOX 6289
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City | DOTHAN
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State | AL
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Zip | 36302-6289
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Country | US
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Telephone | 334-699-3320
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Fax | 334-699-3342
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0057744
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME108836
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 28758
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License Number State | AL
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