| Dothan Behavioral Medicine Clinic Pc | |
|
408 Healthwest Dr Dothan AL 36303-2054 | |
| (334) 702-7222 | |
| (334) 702-1944 |
| Full Name | Dothan Behavioral Medicine Clinic Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 408 Healthwest Dr, Dothan, Alabama |
| Authorized Official Name and Position | Tami Johson (OFFICE MANAGER) |
| Authorized Official Contact | 3347027222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dothan Behavioral Medicine Clinic Pc 101 Medical Dr Dothan AL 36303-6903 Ph: (334) 702-7222 | Dothan Behavioral Medicine Clinic Pc 408 Healthwest Dr Dothan AL 36303-2054 Ph: (334) 702-7222 |
| NPI Number | 1336277540 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 07/29/2020 |
| Certification Date | 07/29/2020 |
| Medicare PECOS PAC ID | 6305833724 |
|---|---|
| Medicare Enrollment ID | O20040428000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336277540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 19943 (Alabama) | Primary |
| Provider Name | Nelson M Handal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154471548 PECOS PAC ID: 2860489184 Enrollment ID: I20080609000283 |
| Provider Name | Jerlyn C Mccleod |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972659407 PECOS PAC ID: 7315005147 Enrollment ID: I20081023000492 |
| Provider Name | Jonathan C Pfeifer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235330374 PECOS PAC ID: 7214053388 Enrollment ID: I20140513001427 |
| Provider Name | Kerri Lyn Outlaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740821958 PECOS PAC ID: 9234049776 Enrollment ID: I20200318002506 |
| Provider Name | Jennifer Ethel Sizemore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255965919 PECOS PAC ID: 5597189456 Enrollment ID: I20200901002992 |
| Provider Name | Tiffany J Britt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649880014 PECOS PAC ID: 4587069877 Enrollment ID: I20210825001067 |
| Provider Name | Temeka Taylor Buggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154817799 PECOS PAC ID: 7719229871 Enrollment ID: I20221128000256 |
| Provider Name | Harriet E Bissette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356192371 PECOS PAC ID: 5991241598 Enrollment ID: I20240718004576 |
| Provider Name | Lakebra Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285432773 PECOS PAC ID: 2860911286 Enrollment ID: I20250528002945 |
| Provider Name | Jerrika P Myles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972302537 PECOS PAC ID: 2365952686 Enrollment ID: I20250606001056 |
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