SAM R BANNER (NPI# 1598833667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598833667 |
| Entity Type | Individual |
| Full Name | SAM R BANNER |
| Credential | DO |
| Practice Address |
1435 W Main St Dothan AL 36301-1311 |
| Practice Telephone | 3347028872 |
| Practice Fax Number | 3347028957 |
| Mailing Telephone | 3347028872 |
| Mailing Fax Number | 3347028957 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | DO190 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BLUE CROSS | 51033060 | 01 |
| Street Address |
1435 W MAIN ST |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-1311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558616029 | Realm Incorporated | Clinic/Center | 1435 W Main St, Dothan, AL 36301-1311 | 2012-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255876181 | Houston County Healthcare Authority | Family Medicine | 4550 W Main St, Suite 1, Dothan, AL 36305-1130 | 2017-01-02 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1124271580 | Right Choice Family Practice | Family Medicine | 290 Healthwest Dr Ste 1, Dothan, AL 36303-2051 | 2008-10-29 |
| 1942466073 | Brandy M. Bodiford | Family Medicine | 4550 W Main St Ste 1, Dothan, AL 36305-1130 | 2008-07-29 |
| 1053406777 | Catherine Teresa James - Peters | Family Medicine | 4126 W Main St, Dothan, AL 36305-9310 | 2006-10-04 |
| 1235238635 | Wiregrass Family Practice of Dothan PC | Family Medicine | 1836 W Main St, Dothan, AL 36301-1320 | 2006-09-22 |
| 1083714042 | James S Sullivan M.d. Pa | Family Medicine | 4300 Main St W, Suite 16, Dothan, AL 36301-1098 | 2006-09-22 |
| 1528161015 | James A Robeson | Family Medicine | 207 W Adams Street, Covenant Hospice, Dothan, AL 36303 | 2006-09-07 |
| 1508893116 | Homer Leon Lassiter Jr. | Family Medicine | 500 Healthwest Drive, Dothan, AL 36303 | 2006-06-27 |
| 1033163183 | Gaynel Barry Taylor | Family Medicine | 1206 Columbia Hwy, Dothan, AL 36301-1826 | 2006-05-22 |
| Find all providers in DOTHAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.