Omohundro, Craig Dean

Omohundro, Craig Dean is an individual health care provider with primary practice located at 4300 W Main St Suite 102, Dothan AL 36305-1054. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Omohundro, Craig Dean can be contacted via phone (334) 793-9564.

Contact Information

Primary practice address
4300 W Main St Suite 102 Dothan AL 36305-1054
Phone: (334) 793-9564
Fax: (334) 671-8907
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 20605 Alabama
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 20605 Alabama

Profile Details

NPI number 1457346850
LBN Legal business name Omohundro, Craig Dean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2005
Last updated Oct 22nd, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457346850 NPPES
Florida MEDICAID 255070900
Florida MEDICAID 00749185A
Florida MEDICAID 000032376

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