Organization Active NPI

Dothan Neurology Clinic, PC

  • Neurology Physician
  • Dothan, AL
National Provider Identifier
1003896887
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
DOTHAN NEUROLOGY CLINIC, PC
Practice address
4300 W Main St
Suite 102
Dothan, AL 36305-1054
Phone
(334) 793-9564
Fax
(334) 671-8907
NPI assigned
Jan 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Lois W Sallas
Title
Administrator
Phone
(334) 793-9564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

4300 W Main St
Suite 102
Dothan, AL 36305-1054

Mailing address

4300 W Main St
Suite 102
Dothan, AL 36305-1054
Phone (334) 793-9564

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003896887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051054",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W MAIN ST",
            "address_2": "SUITE 102",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051054",
            "telephone_number": "334-793-9564",
            "fax_number": "334-671-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOTHAN NEUROLOGY CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SALLAS",
        "authorized_official_first_name": "LOIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-793-9564",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.