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AFFILIATED DERMATOLOGY, PC
NPI 1124008636
Dermatology - Procedural Dermatology in Dothan, AL

Active since January 19, 2006CLIA 01D0304727 · Certificate of Compliance
4300 W MAIN ST, SUITE 102, DOTHAN, AL 36305(334) 793-9564(334) 671-8907 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Affiliated Dermatology, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AFFILIATED DERMATOLOGY, PC (NPI 1124008636) is a healthcare organization registered as a procedural dermatology in Dothan, Alabama and active in the NPI registry since January 2006. The organization holds a CLIA Certificate of Compliance certificate valid through April 22, 2028 and lists Lois W Sallas, Administrator, as its authorized official.

NPPES Registry Identity

NPI1124008636
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameAFFILIATED DERMATOLOGY, PC
Location Address4300 W MAIN ST, SUITE 102Dothan, AL 36305-1054
Mailing Address4300 W Main St, Suite 102Dothan, AL 36305-1054 · (334) 793-9564 · Fax (334) 671-8907
Phone(334) 793-9564
Fax(334) 671-8907
Organization SubpartNo
Authorized OfficialLois W SallasAdministrator · (334) 793-9564
Enumeration DateJanuary 19, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1124008636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
Also ListedDermatologyTaxonomy 207N00000X
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
4300 W MAIN ST, Dothan, AL 36305
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 01D0304727

Affiliated Dermatology · Dothan, AL
Active · expires Apr 22, 2028
CLIA Number01D0304727
Laboratory TypePhysician Office
Certificate Effective DateApril 23, 2026
Certificate Expiration DateApril 22, 2028
Laboratory DirectorCraig D. Omohundro
Laboratory Phone(334) 793-9564
Laboratory LocationAffiliated Dermatology4300 West Main St, Suite 102, Dothan, AL 36305
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PARKS WINFIELD PRATT III MD
Internal Medicine (Rheumatology)
4300 W MAIN ST, SUITE 102
DOTHAN, AL 36305
Houston County (334) 793-9564
DOTHAN NEUROLOGY CLINIC, PC
Psychiatry & Neurology (Neurology)
4300 W MAIN ST, SUITE 102
DOTHAN, AL 36305
Houston County (334) 793-9564
HOUSTON ORTHOPEDICS, PC
Orthopaedic Surgery
4300 W MAIN ST, SUITE 102
DOTHAN, AL 36305
Houston County (334) 793-9564
MS. CYNTHIA MILSTEAD NP
Nurse Practitioner (Family)
4300 W MAIN ST, SUITE 300
DOTHAN, AL 36305
Houston County (334) 446-0076
EMILY ELIZABETH CANNON M.D.
Surgery
4300 W MAIN ST, STE 24
DOTHAN, AL 36305
Houston County (334) 793-1534
BRADLEY TYLER MARKER MD
Surgery
4300 W MAIN ST, SUITE 24
DOTHAN, AL 36305
Houston County (334) 793-1534
ROBERT RONNIE HARRELL M.D.
Internal Medicine (Cardiovascular Disease)
4300 W MAIN ST, SUITE 102
DOTHAN, AL 36305
Houston County (334) 793-9564
TIMOTHY HUGH GANNON MD
Specialist
4300 W MAIN ST, SUITE 403
DOTHAN, AL 36305
Houston County (334) 793-4788

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Affiliated Dermatology, PC's NPI number?

The NPI number for Affiliated Dermatology, PC is 1124008636. It was assigned to this organization in the NPPES registry on January 19, 2006.

Where is Affiliated Dermatology, PC located?

Affiliated Dermatology, PC is located at 4300 W Main St Suite 102, Dothan, AL 36305. The listed phone number is (334) 793-9564.

What is Affiliated Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Does Affiliated Dermatology, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 01D0304727) is associated with this NPI, valid through April 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Affiliated Dermatology, PC accept?

Health plans from Ambetter Health, Ambetter from Magnolia Health, Ambetter of Alabama and Ambetter of Tennessee list Affiliated Dermatology, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Affiliated Dermatology, PC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.