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Organization

DOTHAN SURGICAL SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JASON D BEAVER MD (PHYSICIAN/ OWNER)
(334) 699-7900
Entity
Organization

Contact information

Practice address
4300 W MAIN ST, DOTHAN, AL 36305-1054
(334) 699-7900
(334) 699-7901
Mailing address
4300 W MAIN ST, DOTHAN, AL 36305-1054
(334) 699-7900
(334) 699-7901

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
21102
AL

Other

Enumeration date
07/19/2011
Last updated
07/19/2011
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