Individual
DR. DIANE KLIVINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, MS
Contact information
Practice address
104 MEDICAL DR, DOTHAN, AL 36303-6902
(850) 333-5113
Mailing address
104 MEDICAL DR, DOTHAN, AL 36303-6902
(850) 333-5113
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1313
HI
207V00000X
Obstetrics & Gynecology Physician
Primary
2094
AL
207V00000X
Obstetrics & Gynecology Physician
21472
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04674024
—
MS
Enumeration date
02/19/2007
Last updated
12/08/2020
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