Active NPI 1336134733 Individual Practitioner Female Practitioner

Dr. Tonia L Ruddock , MD

Dermatology • Dothan, AL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Tonia Ruddock, MD is a certified Dermatology practicing in Dothan, AL. With approximately 32 years of clinical experience since graduating from Indiana University School Of Medicine in 1994, Dr. Ruddock delivers high-quality medical care to the local community at 107 MEDICAL DR.

Dr. Ruddock is affiliated with Dermatology And Skin Health Of Dothan, P.C. and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

107 Medical Dr

Dothan, AL 363036903

Telephone 3348287546

Fax 3348287547

Medicare Profile & Education

Medical School

Indiana University School Of Medicine

Graduation Year

1994

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Dothan, AL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

32 Yrs +2.8 yrs vs City Avg

City Avg: 29.2 Yrs

State Avg: 25.7 Yrs

Regional Practice Density

7 Specialists

Practicing in Dothan, AL (178 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

55.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ruddock (32 Years) 32 Yrs

Dothan Specialty Average (29.2 Years) 29.2 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,442	350	$13.32	$6.00
99213 Established patient office or other outpatient visit, typically 15 minutes	1,237	946	$166.72	$84.10
17000 Destruction of skin growth	673	524	$121.47	$50.43
11102 Tangential biopsy of single skin lesion	385	340	$178.50	$83.46
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	288	259	$102.71	$52.15
17110 Destruction of up to 14 skin growths	234	211	$202.60	$101.68
11103 Biopsy of related skin growth, each additional growth	123	94	$89.58	$45.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	105	74	$236.08	$117.52
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	99	89	$543.01	$273.38
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	85	85	$202.39	$101.94
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	80	72	$439.84	$113.11
99202 New patient office or other outpatient visit, typically 20 minutes	50	50	$131.44	$67.11
69100 Biopsy of ear	33	27	$170.66	$62.52
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	25	20	$321.30	$148.53
11200 Removal of skin tag, 1-15 skin tags	23	22	$166.09	$72.05
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	18	18	$556.12	$286.19
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	16	$455.37	$117.20
11104 Punch biopsy, first skin growth	15	15	$221.36	$113.62
17004 Destruction of precancer skin growth, 15 or more growths	12	11	$299.37	$153.42
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	11	11	$266.88	$124.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,384	339	$13.38	$6.09
99213 Established patient office or other outpatient visit, typically 15 minutes	1,239	922	$169.16	$84.00
17000 Destruction of skin growth	658	528	$123.78	$50.90
11102 Tangential biopsy of single skin lesion	423	360	$185.89	$87.13
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	413	352	$105.08	$52.52
17110 Destruction of up to 14 skin growths	254	228	$206.96	$101.24
11103 Biopsy of related skin growth, each additional growth	119	90	$92.58	$45.64
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	107	107	$207.54	$104.17
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	95	86	$560.71	$281.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	87	64	$239.89	$117.84
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	76	68	$452.47	$113.60
99202 New patient office or other outpatient visit, typically 20 minutes	49	49	$131.97	$67.03
11200 Removal of skin tag, 1-15 skin tags	36	36	$168.48	$66.99
69100 Biopsy of ear	33	27	$177.85	$64.08
11104 Punch biopsy, first skin growth	28	27	$230.52	$111.56
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	14	14	$467.78	$117.42
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	14	14	$272.29	$122.22
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	13	13	$573.26	$287.85
17004 Destruction of precancer skin growth, 15 or more growths	12	11	$311.52	$156.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,406	340	$13.84	$6.29
99213 Established patient office or other outpatient visit, typically 15 minutes	1,257	940	$161.95	$86.24
17000 Destruction of skin growth	622	500	$122.36	$50.48
11102 Tangential biopsy of single skin lesion	450	372	$183.82	$88.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	337	287	$100.98	$53.76
17110 Destruction of up to 14 skin growths	244	224	$200.36	$104.41
11103 Biopsy of related skin growth, each additional growth	135	92	$91.47	$48.38
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	100	69	$239.60	$123.21
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	98	83	$540.04	$284.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	90	90	$203.15	$107.70
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	84	71	$431.22	$115.72
11200 Removal of skin tag, 1-15 skin tags	36	36	$156.53	$66.64
11104 Punch biopsy, first skin growth	32	29	$222.69	$120.26
69100 Biopsy of ear	32	32	$177.55	$76.27
99202 New patient office or other outpatient visit, typically 20 minutes	26	26	$134.79	$69.69
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	13	$306.11	$155.15
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	14	$250.18	$131.21
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	16	$559.84	$297.72
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	16	$456.73	$120.71
10060 Simple or single drainage of skin abscess	13	11	$236.52	$118.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,572	369	$20.00	$6.00
99213 Established patient office or other outpatient visit, typically 15 minutes	1,334	1,036	$93.92	$87.09
17000 Destruction of skin growth	640	525	$93.00	$49.63
11102 Tangential biopsy of single skin lesion	450	387	$137.00	$89.31
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	377	326	$59.43	$53.31
17110 Destruction of up to 14 skin growths	308	282	$127.00	$104.97
11103 Biopsy of related skin growth, each additional growth	148	105	$74.00	$50.25
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	94	94	$122.00	$107.05
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	89	80	$350.00	$289.08
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	72	65	$282.00	$117.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	61	53	$142.36	$122.74
99202 New patient office or other outpatient visit, typically 20 minutes	41	41	$85.00	$70.27
69100 Biopsy of ear	35	34	$120.00	$71.65
11200 Removal of skin tag, 1-15 skin tags	32	32	$98.00	$61.75
11104 Punch biopsy, first skin growth	32	30	$172.00	$123.20
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	26	21	$200.00	$154.54
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	16	14	$292.00	$130.46
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	14	$334.00	$298.99
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	15	$164.00	$132.25
17004 Destruction of precancer skin growth, 15 or more growths	13	12	$360.00	$157.71
17111 Destruction of skin growth, 15 or more growths	11	11	$150.00	$126.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,777	423	$20.00	$5.61
99213 Established patient office or other outpatient visit, typically 15 minutes	1,320	1,060	$82.03	$71.19
17000 Destruction of skin growth	747	626	$93.00	$49.59
11102 Tangential biopsy of single skin lesion	494	424	$137.00	$85.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	362	336	$122.06	$103.35
17110 Destruction of up to 14 skin growths	307	285	$127.00	$101.89
11103 Biopsy of related skin growth, each additional growth	199	125	$74.00	$49.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	199	168	$52.04	$42.78
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	111	98	$350.00	$281.58
99202 New patient office or other outpatient visit, typically 20 minutes	103	103	$85.00	$72.30
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	91	79	$282.00	$115.64
11104 Punch biopsy, first skin growth	32	32	$172.00	$114.77
69100 Biopsy of ear	31	29	$120.00	$66.06
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	24	23	$334.00	$250.23
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	23	18	$200.00	$149.65
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	23	21	$292.00	$126.74
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	23	23	$122.00	$102.83
99201 New patient office or other outpatient visit, typically 10 minutes	21	21	$50.00	$41.95
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	19	11	$440.00	$390.83
17004 Destruction of precancer skin growth, 15 or more growths	17	13	$360.00	$149.65
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	16	16	$318.00	$142.60
11200 Removal of skin tag, 1-15 skin tags	13	13	$98.00	$71.54
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	13	11	$152.00	$121.52
87220 Tissue fungi or parasites	13	13	$6.00	$4.22
17111 Destruction of skin growth, 15 or more growths	11	11	$150.00	$123.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,147	498	$20.00	$5.12
99213 Established patient office or other outpatient visit, typically 15 minutes	1,446	1,154	$82.00	$69.42
17000 Destruction of skin growth	890	731	$93.00	$47.22
11102 Tangential biopsy of single skin lesion	653	565	$137.00	$85.03
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	505	445	$122.00	$101.71
17110 Destruction of up to 14 skin growths	361	328	$127.00	$99.57
11103 Biopsy of related skin growth, each additional growth	234	169	$74.00	$48.95
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	230	179	$52.00	$41.46
99202 New patient office or other outpatient visit, typically 20 minutes	153	153	$85.00	$71.10
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	117	111	$350.00	$281.65
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	86	83	$282.00	$115.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	68	68	$122.00	$100.81
69100 Biopsy of ear	53	49	$120.00	$61.83
11104 Punch biopsy, first skin growth	50	49	$172.00	$112.19
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	39	19	$440.00	$347.80
17004 Destruction of precancer skin growth, 15 or more growths	36	34	$360.00	$140.79
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	33	28	$200.00	$143.81
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	29	19	$152.00	$100.41
87220 Tissue fungi or parasites	22	21	$6.00	$4.65
99201 New patient office or other outpatient visit, typically 10 minutes	21	21	$50.00	$42.53
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	20	19	$164.00	$117.31
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	20	19	$292.00	$107.14
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	19	19	$334.00	$238.48
11200 Removal of skin tag, 1-15 skin tags	18	18	$98.00	$61.69
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	15	15	$318.00	$140.54
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	12	$184.00	$90.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,956	461	$20.00	$4.66
99213 Established patient office or other outpatient visit, typically 15 minutes	1,416	1,133	$82.00	$67.18
17000 Destruction of skin growth	809	696	$93.00	$48.42
11100 Biopsy of single growth of skin and/or tissue	644	570	$120.00	$89.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	351	328	$122.00	$99.16
17110 Destruction of up to 14 skin growths	259	246	$127.00	$100.16
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	231	178	$52.00	$40.23
11101 Biopsy of each additional growth of skin and/or tissue	187	124	$42.00	$29.77
99202 New patient office or other outpatient visit, typically 20 minutes	148	148	$85.00	$69.53
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	98	83	$350.00	$262.86
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	69	59	$282.00	$111.97
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	66	66	$122.00	$98.55
69100 Biopsy of ear	49	45	$120.00	$69.91
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	49	24	$440.00	$381.93
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	34	24	$152.00	$99.39
11200 Removal of skin tag, 1-15 skin tags	30	30	$98.00	$67.11
99201 New patient office or other outpatient visit, typically 10 minutes	27	27	$50.00	$40.96
17004 Destruction of precancer skin growth, 15 or more growths	22	18	$360.00	$132.19
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	21	20	$292.00	$106.27
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	19	18	$334.00	$222.83
87220 Tissue fungi or parasites	14	14	$6.00	$4.79
10060 Simple or single drainage of skin abscess	13	12	$130.00	$109.48
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	13	13	$200.00	$145.32
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	11	11	$325.00	$158.02

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,133	493	$20.01	$5.00
99213 Established patient office or other outpatient visit, typically 15 minutes	1,293	1,038	$82.00	$67.17
17000 Destruction of skin growth	856	710	$93.01	$48.97
11100 Biopsy of single growth of skin and/or tissue	623	538	$120.00	$88.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	395	353	$122.00	$98.40
17110 Destruction of up to 14 skin growths	298	272	$127.00	$97.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	238	175	$52.00	$39.75
11101 Biopsy of each additional growth of skin and/or tissue	202	131	$42.00	$29.79
99202 New patient office or other outpatient visit, typically 20 minutes	165	165	$85.00	$68.90
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	116	112	$350.65	$269.77
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	100	93	$282.00	$111.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	76	76	$122.00	$99.02
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	55	30	$372.62	$334.96
69100 Biopsy of ear	46	42	$120.00	$66.82
11200 Removal of skin tag, 1-15 skin tags	44	42	$98.00	$59.67
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	38	30	$152.00	$113.48
99201 New patient office or other outpatient visit, typically 10 minutes	30	30	$50.00	$40.34
11622 Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm	23	23	$292.00	$116.88
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	22	20	$200.00	$133.96
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	20	20	$334.00	$263.81
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	18	18	$325.00	$130.84
10040 Acne surgery	17	17	$118.00	$77.08
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	17	17	$352.00	$268.27
17004 Destruction of precancer skin growth, 15 or more growths	16	14	$360.00	$136.87
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	12	$189.92	$76.38
87220 Tissue fungi or parasites	12	12	$6.00	$3.90
17111 Destruction of skin growth, 15 or more growths	11	11	$150.00	$114.40

Medical Specialties & State Licenses

CMS Verified: 2023-01-25

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License AL 26056

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

140835009A (GA)

Medicaid State Provider ID

051554856 (AL)

Hospital & Practice Group Affiliations

Dermatology And Skin Health Of Dothan, P.c.

107 Medical Dr, Dothan, AL 363036903

Phone: 3348287546

Secondary Practice Locations

4300 W Main St, Suite 102

Dothan, AL 363051054

Phone: 3347939564

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Laura Tamburin , MD

Dermatology

NPI 1346235744

Doctor of Medicine (M.D.)

Dana Culpepper , PA-C

Physician Assistant - Medical

NPI 1699083501

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location January 25, 2023

Registered at 107 MEDICAL DR, DOTHAN, AL 363036903 (Tel: 3348287546)

📍

Updated Business Mailing Address January 25, 2023

Registered at 107 MEDICAL DR, DOTHAN, AL 363036903 (Tel: 3348287546)

✅

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location July 08, 2007

Registered at 4300 W MAIN ST, SUITE 102, DOTHAN, AL 363051054 (Tel: 3347939564)

📍

Updated Business Mailing Address July 08, 2007

Registered at 4300 W MAIN ST, SUITE 102, DOTHAN, AL 363051054 (Tel: 3347939564)

👤

Provider Name / Credentials Updated July 08, 2007

Recorded as TONIA RUDDOCK, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dermatology (License #26056 in AL)

🟢

Initial NPI Registration & Enumeration September 13, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1336134733

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: September 13, 2005

Last Update: January 25, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

107 Medical Dr

Dothan, AL 363036903

Phone: 3348287546

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.