SOUTHERN ALABAMA PHYSICIANS LLP (NPI# 1467701490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467701490 |
| Entity Type | Organization |
| Organization Name | SOUTHERN ALABAMA PHYSICIANS LLP |
| Practice Address |
4370 W Main St Dothan AL 36305-1056 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 3376091382 |
| Practice Fax Number | 3347934613 |
| Mailing Telephone | 3376091382 |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2017-11-27 |
| Authorized Official Name | DR. DERIK K KING (LLP MANAGING PARTNER) |
| Authorized Official Telephone | 8008939698 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 142274 | 05 | |
| FL | 007664700 | 05 |
| Street Address |
4370 W MAIN ST |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305-1056 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629061619 | Richard D Key | Pathology | 4370 W Main St, Dothan, AL 36305-1056 | 2005-08-25 |
| 1467064089 | Regan Woodham | Nurse Practitioner | 4370 W Main St, Dothan, AL 36305-4000 | 2020-08-17 |
| 1871114090 | Hillary Ryan Mclemore | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-4000 | 2020-04-28 |
| 1255981908 | Jessica Pastino | Dietitian, Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2019-09-15 |
| 1255980439 | Madeline Eidson | Nurse Practitioner | 4370 W Main St, Dothan, AL 36305-4000 | 2019-09-10 |
| 1720646102 | Austin Wyatt Bivins | Nurse Practitioner | 4370 W Main St, Dothan, AL 36305-4000 | 2019-05-31 |
| 1972076859 | Tillman Hall | Nurse Anesthetist, Certified Registered | 4370 W Main St, Dothan, AL 36305-1056 | 2019-01-03 |
| 1245713684 | App of Alabama Hm, LLC | Hospitalist | 4370 W Main St, Dothan, AL 36305-1056 | 2018-09-12 |
| 1376029744 | Debra Elaine Phillips | Nurse Practitioner | 4370 W Main St, Dothan, AL 36305-4000 | 2018-07-18 |
| 1801382478 | Veronica Diane Doss | Nurse Practitioner | 4370 W Main St, Dothan, AL 36305 | 2018-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467664870 | Rita Margaret Mary Gillespie | Emergency Medicine | 1103 Ross Clark Circle, Dothan, AL 36301 | 2007-05-06 |
| 1871560599 | Daniel Leon Turley | Emergency Medicine | 4370 W Main Street, Dothan, AL 36305 | 2006-03-01 |
| 1255305041 | Rick Marcus Weber | Emergency Medicine | 1052 Ross Clark Circle, Dothan, AL 36303 | 2006-02-16 |
| 1144664194 | Patrick William Jones | Emergency Medicine | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2013-04-22 |
| 1164788774 | Jesse Bryan Basford | Emergency Medicine | 1108 Ross Clark Cir, Emergency Department, Dothan, AL 36301 | 2012-04-09 |
| 1073742953 | Nowoghomwenma Charles Ibie | Emergency Medicine | 207 Haven Dr, Dothan, AL 36301-2919 | 2009-07-13 |
| 1962608455 | Frederick Albert Pich IIi | Emergency Medicine | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2007-06-22 |
| 1285783134 | Houston County Healthcare Authority | Emergency Medicine | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2007-01-09 |
| 1427121029 | Jason Deleon | Emergency Medicine | 1108 Ross Clark Cir, Dothan, AL 36301-3022 | 2006-11-15 |
| 1578587093 | Albert Miller | Emergency Medicine | 4370 W Main St, Dothan, AL 36305 | 2006-07-27 |
| Find all providers in DOTHAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.