| Medpeds Of Dothan Inc | |
|
318 Westgate Pkwy Ste 2 Dothan AL 36303-2963 | |
| (334) 671-2895 | |
| (334) 712-9430 |
| Full Name | Medpeds Of Dothan Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 318 Westgate Pkwy Ste 2, Dothan, Alabama |
| Authorized Official Name and Position | Kristin Boutwell (ADMINISTRATION) |
| Authorized Official Contact | 3346712895 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medpeds Of Dothan Inc 318 Westgate Parkway Ste 2 Dothan AL 36303 Ph: (334) 671-2895 | Medpeds Of Dothan Inc 318 Westgate Pkwy Ste 2 Dothan AL 36303-2963 Ph: (334) 671-2895 |
| NPI Number | 1427252766 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 07/16/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427252766 | NPI | - | NPPES |
| 009946055 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 00024928 (Alabama) | Primary |
| 2080A0000X | Pediatrics - Adolescent Medicine | 00024928 (Alabama) | Secondary |
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