SOUTHEASTERN UROLOGY, PC (NPI# 1760023634) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760023634 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN UROLOGY, PC |
| Practice Address |
4300 W Main St Ste 102 Dothan AL 36305-1306 |
| Practice Telephone | 3347939564 |
| Practice Fax Number | 3346718907 |
| Mailing Telephone | 3347939564 |
| Mailing Fax Number | 3346718907 |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |
| Authorized Official Name | DR. DANIEL DEIGHTON (OWNER) |
| Authorized Official Telephone | 3347939564 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Street Address |
4300 W MAIN ST STE 102 |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305-1306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1932692282 | Magan Parker | Nurse Practitioner | 4300 W Main St Ste 102, Dothan, AL 36305-1306 | 2018-06-12 |
| 1427555226 | Laboratory Corportation of America Holdings | Clinical Medical Laboratory | 4300 W Main St Ste 102, Dothan, AL 36305-1306 | 2018-04-09 |
| 1558871830 | Brittney H Edge | Nurse Practitioner | 4300 W Main St Ste 102, Dothan, AL 36305-1306 | 2017-10-02 |
| 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 |
| 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 |
| 1538217237 | Randall Scott Hall | Chiropractor | 303 Regency Court, Dothan, AL 36305 | 2007-01-08 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| 1710984950 | Rube R Hundley | Urology | 1245 Westgate Pkwy, Dothan, AL 36303-2151 | 2005-07-01 |
| 1497112692 | Shelor & Hundley Urology PC | Urology | 1245 Westgate Pkwy, Dothan, AL 36303-2151 | 2016-01-20 |
| 1336514389 | Tri-state Urology, P.C. | Urology | 4300 W Main St, Suite 102, Dothan, AL 36305-1054 | 2015-12-02 |
| 1013130186 | Joseph Jason Phillips | Urology | 1118 Ross Clark Cir, 500, Dothan, AL 36301-3001 | 2007-04-10 |
| 1780758359 | Wiregrass Urology, PC | Urology | 4300 W Main St, Suite 102, Dothan, AL 36305-1054 | 2006-11-17 |
| 1245202944 | Urological Associates of Dothan,p.a. | Urology | 1118 Ross Clark Cir, Suite 500, Dothan, AL 36301-3001 | 2006-02-06 |
| 1215917745 | Dothan Urology, PC | Urology | 4300 W Main St, Suite 102, Dothan, AL 36305-1054 | 2006-01-19 |
| 1043205164 | Mark Allen Byard | Urology | 4370 W Main St, Dothan, AL 36305-1056 | 2005-09-14 |
| 1972501617 | Mark W Fischer | Urology | 1118 Ross Clark Cir, 500, Dothan, AL 36301-3001 | 2005-07-07 |
| 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.