Organization
PAUL H. CHAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLENDA A JONES CMA (OFFICE MANAGER)
(334) 678-1400
Entity
Organization
Contact information
Practice address
1800 FAIRVIEW AVE, SUITE 2, DOTHAN, AL 36301-3058
(334) 678-1400
(334) 678-1432
Mailing address
PO BOX 1525, DOTHAN, AL 36302-1525
(334) 678-1400
(334) 678-1432
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
13615
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529913350
—
AL
01
—
DE5059
RRMC
AL
Enumeration date
09/19/2007
Last updated
12/23/2014
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