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Organization
DOTHAN PEDIATRIC CLINIC, P. A.
Active
Organization
DOTHAN PEDIATRIC CLINIC, P. A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA TOLAR (INSURANCE & COLLECTION SUPERVISOR)
(334) 793-1881
Entity
Organization
Contact information
Practice address
126 CLINIC DR, DOTHAN, AL 36303-1980
(334) 793-1881
(334) 712-1815
Mailing address
126 CLINIC DR, DOTHAN, AL 36303-1980
(334) 793-1881
(334) 712-1815
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
208000000X
Pediatrics Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
04/19/2006
Last updated
07/22/2021
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