NPI 1124008636

Affiliated Dermatology, PC

Organisation Procedural Dermatology Physician Dothan, AL

Practice location

Address: 4300 W Main St Suite 102, Dothan, AL 36305-1054
Phone: (334) 793-9564
Fax: (334) 671-8907

Authorised official

Name: Lois W Sallas
Title: Administrator
Phone: (334) 793-9564

Registered specialties (3)

Procedural Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207NS0135X

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Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

MOHS-Micrographic Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 207ND0101X

Registry record

NPI: 1124008636
Entity type: Organization
NPI issued: 19 Jan 2006
Record last updated: 11 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.