Paul H. Chan MD PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

13615 Issued in AL

Legal business name

PAUL H. CHAN MD PC

Practice address

1800 Fairview Ave
Suite 2
Dothan, AL 36301-3058

Phone

(334) 678-1400

Fax

(334) 678-1432

NPI assigned

Sep 19, 2007

Last updated

Dec 23, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Glenda A Jones, CMA

Title

Office Manager

Phone

(334) 678-1400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1114113578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1525",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363021525",
            "telephone_number": "334-678-1400",
            "fax_number": "334-678-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FAIRVIEW AVE",
            "address_2": "SUITE 2",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363013058",
            "telephone_number": "334-678-1400",
            "fax_number": "334-678-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL H. CHAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "GLENDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "334-678-1400",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AL",
            "license": "13615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "DE5059",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529913350",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pathology Laboratory Associates
• Patients 1St of Dothan, LLC
• Jennifer Cherese Patrick, OTRL
• Damon Patterson, MD
• Patricia Allison Patterson, M.S. CCC-SLP
• Paul W. Adams, MD, PC (21st Century Oncology)
• Charles Ted Paulk, MD
• Brandy Michelle Paulson, NP
• David Payne, PH.D
• Makaila Jade Payne, RBT PENDING

• Primary Care Clinic/Center in Dothan, AL
• Providers in Dothan, AL by specialty
• Primary Care Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.