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Organization

DOTHAN INTERNAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RODNEY K BEAUCHAMP M.D. (PRESIDENT)
(334) 699-2004
Entity
Organization

Contact information

Practice address
1118 ROSS CLARK CIR, SUITE 105, DOTHAN, AL 36301-3001
(334) 699-2004
(334) 699-2006
Mailing address
1118 ROSS CLARK CIR, SUITE 105, DOTHAN, AL 36301-3001
(334) 699-2004
(334) 699-2006

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00020759
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51522252
BCBS
AL
05
529919960
AL
Enumeration date
01/02/2007
Last updated
01/31/2008
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