Individual provider Active NPI

Guy Malcolm Middleton, M.D.

  • Obstetrics & Gynecology Physician
  • Dothan, AL
National Provider Identifier
1053410993
Registry record updated Feb 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
25364 Issued in AL
Practice address
1118 Ross Clark Cir
Suite 402
Dothan, AL 36301-3001
Phone
(334) 673-3633
Fax
(334) 836-2893
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 25364 AL Primary

Addresses

Primary practice location

1118 Ross Clark Cir
Suite 402
Dothan, AL 36301-3001

Mailing address

1118 Ross Clark Cir
Suite 402
Dothan, AL 36301-3001
Phone (334) 673-3633

Other identifiers 3

IdentifierTypeStateIssuer
74-10781OtherALUNITED HEALTHCARE
16691OtherFLBLUE CROSS BLUE SHIELD
515-16936OtherALBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000299 AL Practitioner - Obstetrics/Gynecology 6406989052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Alabama School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dothan OBGYN, Inc.Group PAC ID 8022042076, 6 clinicians

Practice addresses (Care Compare)

1118 Ross Clark Cir
Suite 402
Dothan, AL 36301-3002
Phone (334) 673-3633

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25364ALMDObstetrics & Gynecology Physician
21912SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dothan OBGYN, Inc. Obstetrics & Gynecology CurrentSince Oct 1, 2003 Accepting new patients
Lancaster Women's Center,P.a. Past Accepting new patients
Houston County Healthcare Authority Past Accepting new patients

Locations

1118 Ross Clark Cir
Ste 402
Dothan, AL 36301
Phone (334) 673-3633

Interoperability endpoints

  • Direct secure messaging: gmiddleton14403@southeasthealth.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202083200000",
    "number": "1053410993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 402",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-673-3633",
            "fax_number": "334-836-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 ROSS CLARK CIR",
            "address_2": "SUITE 402",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013001",
            "telephone_number": "334-673-3633",
            "fax_number": "334-836-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "GUY",
        "middle_name": "MALCOLM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "25364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "74-10781",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "16691",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "515-16936",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.