OrganizationActive
Affiliated Dermatology, PC
NPI 1124008636 · Procedural Dermatology Physician · Dothan, AL
Provider details
- NPI number
- 1124008636
- Entity type
- Organization
- Primary specialty
- Procedural Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lois Sallas, Administrator(334) 793-9564
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
- MOHS-Micrographic Surgery Physician207ND0101X
Allopathic & Osteopathic Physicians
Practice location
4300 W Main St
Suite 102
Dothan, AL 36305-1054
Phone: (334) 793-9564
Fax: (334) 671-8907
Approximate (ZIP-level) locationGet directions
Mailing address
4300 W Main St
Dothan, AL 36305-1054
Registry dates
- Enumerated
- 2006-01-19
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.