| Paul H. Chan Md Pc | |
|
1800 Fairview Ave Suite 2 Dothan AL 36301-3058 | |
| (334) 678-1400 | |
| (334) 678-1432 |
| Full Name | Paul H. Chan Md Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1800 Fairview Ave, Dothan, Alabama |
| Authorized Official Name and Position | Glenda A Jones (OFFICE MANAGER) |
| Authorized Official Contact | 3346781400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul H. Chan Md Pc Po Box 1525 Dothan AL 36302-1525 Ph: (334) 678-1400 | Paul H. Chan Md Pc 1800 Fairview Ave Suite 2 Dothan AL 36301-3058 Ph: (334) 678-1400 |
| NPI Number | 1114113578 |
|---|---|
| Provider Enumeration Date | 09/19/2007 |
| Last Update Date | 12/23/2014 |
| Medicare PECOS PAC ID | 0042232902 |
|---|---|
| Medicare Enrollment ID | O20051220000929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114113578 | NPI | - | NPPES |
| 529913350 | Medicaid | AL | |
| DE5059 | Other | AL | RRMC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 13615 (Alabama) | Primary |
| Provider Name | Paul H Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154326783 PECOS PAC ID: 4587686449 Enrollment ID: I20051220000945 |
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