| Lash Orthospine And Sports Llc | |
|
2800 Ross Clark Cir Ste 2 Dothan AL 36301-9917 | |
| (480) 262-5758 | |
| Not Available |
| Full Name | Lash Orthospine And Sports Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2800 Ross Clark Cir Ste 2, Dothan, Alabama |
| Authorized Official Name and Position | Dustin Lash (PHYSICIAN/OWNER) |
| Authorized Official Contact | 4802625758 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lash Orthospine And Sports Llc 2800 Ross Clark Cir Ste 2 Dothan AL 36301-9917 Ph: (334) 239-0063 | Lash Orthospine And Sports Llc 2800 Ross Clark Cir Ste 2 Dothan AL 36301-9917 Ph: (480) 262-5758 |
| NPI Number | 1629853312 |
|---|---|
| Provider Enumeration Date | 08/30/2023 |
| Last Update Date | 10/25/2023 |
| Medicare PECOS PAC ID | 6507211554 |
|---|---|
| Medicare Enrollment ID | O20231011000091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629853312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Dustin W Lash |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1639305246 PECOS PAC ID: 9830417427 Enrollment ID: I20150410000881 |
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