NPIMap

Organization Active NPI

General Surgery Associates of Dothan PC

  • Surgery Physician
  • Dothan, AL
National Provider Identifier
1700866233
Registry record updated Sep 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
17006 Issued in AL
Legal business name
GENERAL SURGERY ASSOCIATES OF DOTHAN PC
Practice address
4300 W Main St
Suite 102
Dothan, AL 36305-1054
Phone
(334) 793-9564
Fax
(334) 671-8907
NPI assigned
Jan 19, 2006
Organization subpart
Yes
Parent organization
CHARLES J CARPENTER, JR., MDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2013

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

Authorized official

Name
Charles J Carpenter Jr., MDNPI 1073508404
Title
Owner/Presiden
Phone
(334) 793-9564

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 17006 AL 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

Other identifiers 1

IdentifierTypeStateIssuer
529703840MedicaidAL

Other names 1

  • Charles J. Carpenter, MD Other name

National Provider Directory

National Provider Directory
Part of
Carpenter General Surge

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1700866233",
    "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": "GENERAL SURGERY ASSOCIATES OF DOTHAN PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARLES J CARPENTER, JR., MD",
        "enumeration_date": "2006-01-19",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PRESIDEN",
        "authorized_official_telephone_number": "334-793-9564",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "AL",
            "license": "17006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529703840",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles J. Carpenter, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 3, 2013; 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.