Organization
DERMATOLOGY ASSOCIATES OF DOTHAN, LLC
Active
Other names
Huntsville Dermatology, LLC, Eufaula Dermatology, Dermatology Associates of Dothan, Enterprise Dermatology, Troy Dermatology, Huntsville Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEONARD T PYNES MD (OWNER)
(334) 793-9222
Entity
Organization
Contact information
Practice address
2431 W MAIN ST, STE 501, DOTHAN, AL 36301
(334) 793-9222
(334) 671-0322
Mailing address
2431 W MAIN ST STE 501, DOTHAN, AL 36301-1274
(334) 793-9222
(334) 671-0322
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01D0670555
CLIA
AL
01
—
01D2111151
CLIA TROY
AL
01
—
01D2143273
CLIA HUNTSVILLE
AL
05
—
085296164B
—
GA
05
—
529922330
—
AL
01
—
DG8208
RR MEDICARE
—
Enumeration date
02/22/2007
Last updated
02/08/2019
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