Provider Demographics
NPI:1932326915
Name:DOCKERY, RACHEL TANNER (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:TANNER
Last Name:DOCKERY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 GADSDEN HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3134
Mailing Address - Country:US
Mailing Address - Phone:205-228-7600
Mailing Address - Fax:
Practice Address - Street 1:1801 GADSDEN HWY STE 100
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3134
Practice Address - Country:US
Practice Address - Phone:205-228-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9262255A2300X
ALPA656363AS0400X
363AS0400X
ALPA.656363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical