Jonathan Tyler Proctor, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

24347 Issued in AL

Practice address

4650 W Main St
Dothan, AL 36305-9419

Phone

(334) 792-6824

Fax

(334) 824-6988

NPI assigned

Oct 21, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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

• Publix

  • Pharmacist
  • Dothan, AL
  • NPI 1477001352
  NPD (past)
• Publix Alabama LLC

  • Community/Retail Pharmacy
  • Dothan, AL
  • NPI 1053628826
  NPD (past)

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

{
    "created_epoch": "1761004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1720955180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5369 10TH ST",
            "city": "MALONE",
            "state": "FL",
            "postal_code": "324453428",
            "telephone_number": "334-790-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363059419",
            "telephone_number": "334-792-6824",
            "fax_number": "334-824-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROCTOR",
        "first_name": "JONATHAN",
        "middle_name": "TYLER",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "24347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primecare of Dothan, PC
• Primeteam, Inc.
• Alan David Prince, M.D.
• PRN Staffers Dal
• Pro-Vision Eye Health, LLC
• Professional Counseling and Consulting Service LLC
• Professional Lane Dental Association
• Professional Lane Dental, PLLC
• Professional Resource Management of Wiregrass, LLC
• Professional Resource Management of Wiregrass, LLC

• Pharmacist in Dothan, AL
• Providers in Dothan, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.