Blaxton, Angela S
Blaxton, Angela S is an individual health care provider with primary practice located at 364 Honeysuckle Rd , Dothan AL 36305-1140. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Blaxton, Angela S can be contacted via phone (334) 794-8656.Contact Information
Primary practice address
364 Honeysuckle Rd
Dothan AL 36305-1140
Phone: (334) 794-8656
Fax: (877) 389-4229
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 24249 | Alabama |
Profile Details
| NPI number | 1447257647 |
|---|---|
| LBN Legal business name | Blaxton, Angela S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 1st, 2005 |
| Last updated | Oct 13th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447257647 | NPPES |
| Alabama | MEDICAID | 009915115 | |
| Alabama | Other | 630738893 | |
| Alabama | MEDICAID | 148556002A |
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