Provider Demographics
NPI:1467434787
Name:DOTSON, RANDY GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:GENE
Last Name:DOTSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7987
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-0987
Mailing Address - Country:US
Mailing Address - Phone:251-633-0573
Mailing Address - Fax:251-633-7367
Practice Address - Street 1:141 TUSCALOOSA ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3422
Practice Address - Country:US
Practice Address - Phone:251-433-3344
Practice Address - Fax:251-433-4052
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16421207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL212171Medicaid
AL290004600OtherRR MEDICARE
AL4235591OtherAETNA
AL512-05489OtherBCBS
AL212883Medicaid
AL89566Medicaid
ALF23378OtherVIVA HEALTH
AL221329Medicaid
AL512-05488OtherBCBS
AL88000059OtherCIGNA HC
AL511-95471OtherBCBS
MS001162226OtherMS MEDICAID
AL1201345OtherUHC
AL220703Medicaid
AL000089566OtherMEDICARE
AL510-89566OtherBCBS