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Organization

DOTHAN INTERNAL MEDICINE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RODNEY K BEUACHAMP M.D. (OWNER)
(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
174400000X
Specialist
Primary
20759
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003831983
NPI INDIVIDUAL
AL
Enumeration date
12/23/2014
Last updated
12/23/2014
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