| Southern Clinic Pc | |
|
1901 Melba Dr Dothan AL 36301-3017 | |
| (334) 794-6611 | |
| (334) 794-6614 |
| Full Name | Southern Clinic Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1901 Melba Dr, Dothan, Alabama |
| Authorized Official Name and Position | Brian Holman (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 3347946611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Clinic Pc 1901 Melba Dr Dothan AL 36301-3017 Ph: (334) 794-6611 | Southern Clinic Pc 1901 Melba Dr Dothan AL 36301-3017 Ph: (334) 794-6611 |
| NPI Number | 1053410480 |
|---|---|
| Provider Enumeration Date | 09/22/2006 |
| Last Update Date | 02/01/2008 |
| Medicare PECOS PAC ID | 1355329269 |
|---|---|
| Medicare Enrollment ID | O20040708000585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053410480 | NPI | - | NPPES |
| Q684 | Other | AL | BC/BS OF ALABAMA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Olusina M Akinduro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760451959 PECOS PAC ID: 8921096686 Enrollment ID: I20040503001278 |
| Provider Name | Jeffrey M Elliott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639138795 PECOS PAC ID: 0840278776 Enrollment ID: I20040708000710 |
| Provider Name | Jesse E Morriss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063481273 PECOS PAC ID: 9830177757 Enrollment ID: I20050421000357 |
| Provider Name | Shawna M Mason |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194794370 PECOS PAC ID: 4183756455 Enrollment ID: I20100722000135 |
| Provider Name | Robert C Espy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205130499 PECOS PAC ID: 8224200225 Enrollment ID: I20111018000197 |
| Provider Name | Marien Tavarez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437335999 PECOS PAC ID: 4587732631 Enrollment ID: I20111219000677 |
| Provider Name | Melinda B Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922370063 PECOS PAC ID: 3870752876 Enrollment ID: I20120312000299 |
| Provider Name | Gregory L Gibson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891015574 PECOS PAC ID: 8325202559 Enrollment ID: I20120619000391 |
| Provider Name | Timothy R Waters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083813885 PECOS PAC ID: 9638326556 Enrollment ID: I20120829000254 |
| Provider Name | Michelle N Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922355924 PECOS PAC ID: 7810149754 Enrollment ID: I20121128000700 |
| Provider Name | Carlos S Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063851277 PECOS PAC ID: 3476796277 Enrollment ID: I20130827000105 |
| Provider Name | Kimberly J Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518381854 PECOS PAC ID: 9133351984 Enrollment ID: I20140410001035 |
| Provider Name | Buddy B Stokes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003172313 PECOS PAC ID: 2062632227 Enrollment ID: I20141010000511 |
| Provider Name | Samuel J Braswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609280494 PECOS PAC ID: 1456572460 Enrollment ID: I20141016000402 |
| Provider Name | Haley G Clements |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295143733 PECOS PAC ID: 3779704671 Enrollment ID: I20141017001201 |
| Provider Name | Leah M Mcknight-haas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922394592 PECOS PAC ID: 1052558616 Enrollment ID: I20141205001675 |
| Provider Name | Ashley P Pippin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326444589 PECOS PAC ID: 9335461920 Enrollment ID: I20141210001609 |
| Provider Name | John Burton Calhoun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770845141 PECOS PAC ID: 9638491319 Enrollment ID: I20150805009428 |
| Provider Name | James B Addison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679985055 PECOS PAC ID: 9133425986 Enrollment ID: I20160304000914 |
| Provider Name | James E Goforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154841831 PECOS PAC ID: 3971683889 Enrollment ID: I20170731002243 |
| Provider Name | Trevor Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689104903 PECOS PAC ID: 4587937925 Enrollment ID: I20170906001659 |
| Provider Name | Brittany L Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649763640 PECOS PAC ID: 3274883327 Enrollment ID: I20180911001499 |
| Provider Name | Elizabeth A Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013551811 PECOS PAC ID: 8527494905 Enrollment ID: I20200203001465 |
| Provider Name | Ashley B Maddox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730725508 PECOS PAC ID: 5193151165 Enrollment ID: I20200211001438 |
| Provider Name | Britany D Sasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275100737 PECOS PAC ID: 8426450057 Enrollment ID: I20210706001171 |
| Provider Name | Jerry Iii Wisdom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912570607 PECOS PAC ID: 6204231137 Enrollment ID: I20210816002450 |
| Provider Name | Jessica N Wisdom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811628639 PECOS PAC ID: 2668855040 Enrollment ID: I20220817002758 |
Wiregrass Wound Care Consultants Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1908 Fairview Ave, Dothan, AL 36301 Phone: 251-295-2815 Fax: 251-295-2815 | |
Dothan Family Practice Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1891 Honeysuckle Rd Ste 2a, Dothan, AL 36305 Phone: 334-794-6504 Fax: 334-793-4452 | |
Primecare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4126 West Main Street, Dothan, AL 36305 Phone: 334-793-2120 Fax: 334-671-2930 | |
Samc-houston Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1806 Fairview Ave, Dothan, AL 36301 Phone: 334-677-5986 Fax: 334-677-4901 | |
Carnes Chiropractic And Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2323 W Main St Ste 109, Dothan, AL 36301 Phone: 334-794-2225 | |
Sha Diabetes Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 172 Luds Way, Dothan, AL 36304 Phone: 334-475-0646 Fax: 334-888-8445 |