Provider Demographics
NPI:1639740475
Name:DOGAN, LEAH ALEXIS (PA)
Entity Type:Individual
Prefix:MISS
First Name:LEAH
Middle Name:ALEXIS
Last Name:DOGAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:5085 YORKSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2859
Mailing Address - Country:US
Mailing Address - Phone:205-535-8419
Mailing Address - Fax:
Practice Address - Street 1:401 TOWNCENTER BLVD STE B
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-1822
Practice Address - Country:US
Practice Address - Phone:205-391-9038
Practice Address - Fax:205-391-4688
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1812363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant