Individual
DR. FREDERICK KENT NUNNALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4550 W MAIN ST, DOTHAN, AL 36305-1130
(334) 793-6673
(877) 413-4055
Mailing address
4550 W MAIN ST, DOTHAN, AL 36305-1130
(334) 793-6673
(877) 413-4055
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00016477
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000031972
—
AL
01
—
040010260
RAILROAD MEDICARE
AL
01
—
174014500
US DEPT OF LABOR
AL
Enumeration date
04/03/2006
Last updated
03/11/2022
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