Southern Clinic PC
NPI 1053410480ActiveOrganization· Internal Medicine· Dothan, AL
Internal Medicine in Dothan, Alabama, registered in NPPES in September 2006. The authorized official on file is Brian Holman, Office Administrator. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1053410480 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 22, 2006 |
| Last updated in NPPES | Feb 1, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Nurse Practitioner | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AL); Part B Supplier - Clinic/Group Practice (FL) |
|---|
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