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Organization

ACTION ORTHOTICS & PROSTHETICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUGLAS F MACVICAR CPO, LPO (PRESIDENT)
(334) 699-5462
Entity
Organization

Contact information

Practice address
2191 E MAIN ST, SUITE ONE, DOTHAN, AL 36301-3016
(334) 699-5462
(334) 699-5623
Mailing address
2191 E MAIN ST, STE 1, DOTHAN, AL 36301-3016
(334) 699-5462
(334) 699-5623

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009938579
AL
05
306271899A
GA
01
5718430001
CIGNA GOVERNMENT SERVICES
AL
Enumeration date
06/23/2006
Last updated
07/19/2011
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