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DIANA M MANCUSO MD PA
NPI 1366692246
Family Medicine in Dothan, AL

Active since September 26, 2008
4300 W MAIN ST, SUITE 16, DOTHAN, AL 36305(334) 793-4120(334) 615-8443 Get Directions Write a Review

NPPES record last updated: March 9, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Diana M Mancuso Md Pa NPPES

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

DIANA M MANCUSO MD PA (NPI 1366692246) is a healthcare organization registered as a family medicine in Dothan, Alabama and active in the NPI registry since September 2008. The organization lists Diana M Mancuso, President, as its authorized official.

NPPES Registry Identity

NPI1366692246
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDIANA M MANCUSO MD PA
Location Address4300 W MAIN ST, SUITE 16Dothan, AL 36305-1054
Mailing Address4300 W Main St, Suite 16Dothan, AL 36305-1054 · (334) 793-4120 · Fax (334) 615-8443
Phone(334) 793-4120
Fax(334) 615-8443
Organization SubpartNo
Authorized OfficialDiana M MancusoPresident · (334) 793-4120
Enumeration DateSeptember 26, 2008
Last NPPES UpdateMarch 9, 2009
✔ NPI 1366692246 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in AL · 4436
Definition
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.
4300 W MAIN ST, Dothan, AL 36305
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Other Identifiers 4

Medicare UPINC72543AL
Medicaid000000013AL
Other000000013AL · Medicare Provider Number
Medicare PIN000000013AL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 for Provider-Performed Microscopy Procedures (PPMP) 01D0304710

Diana M Mancuso MD · Dothan, AL
Expired · Aug 18, 2026
CLIA Number01D0304710
Laboratory TypePhysician Office
Certificate Effective DateAugust 19, 2024
Certificate Expiration DateAugust 18, 2026
Laboratory DirectorDiana M. Mancuso
Laboratory Phone(334) 793-4120
Laboratory LocationDiana M Mancuso MD4300 W Main Suite #16, Dothan, AL 36305
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Diana M Mancuso MD PA's NPI number?

The NPI number for Diana M Mancuso MD PA is 1366692246. It was assigned to this organization in the NPPES registry on September 26, 2008.

Where is Diana M Mancuso MD PA located?

Diana M Mancuso MD PA is located at 4300 W Main St Suite 16, Dothan, AL 36305. The listed phone number is (334) 793-4120.

What is Diana M Mancuso MD PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Diana M Mancuso MD PA was last updated on March 9, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.