Organization
DOTHAN PEDIATRIC CLINIC, P. A.
Active
Other names
Enterprise Pediatric Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
GINA TOLAR (INSURANCE & COLLECTIONS SUPERVISOR)
(334) 793-1881
Entity
Organization
Contact information
Practice address
526 BOLL WEEVIL CIR, ENTERPRISE, AL 36330-4012
(334) 308-1166
Mailing address
126 CLINIC DR, DOTHAN, AL 36303-1980
(334) 793-1881
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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