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General NPI Number Information
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NPI Number | 1255466330
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF DOTHAN, LLC
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | 2431 W MAIN ST STE 501
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City | DOTHAN
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State | AL
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Zip | 36301
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Country | US
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Telephone | 334-793-9222
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Fax | 334-671-0322
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Provider Business Mailing Address
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Address Line | 2431 W MAIN ST STE 501
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City | DOTHAN
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State | AL
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Zip | 36301-1274
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Country | US
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Telephone | 334-793-9222
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Fax | 334-671-0322
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEONARD T PYNES
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Credential | MD
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Telephone | 334-793-9222
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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