Provider Demographics
NPI:1740997675
Name:DOT MEDICAL EXAMS 4 U LLC
Entity type:Organization
Organization Name:DOT MEDICAL EXAMS 4 U LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHEROCKO
Authorized Official - Middle Name:RIESHELL
Authorized Official - Last Name:GATLING-JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-807-4710
Mailing Address - Street 1:956 KILLIAN HILL RD SW STE B
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-8977
Mailing Address - Country:US
Mailing Address - Phone:770-335-2434
Mailing Address - Fax:
Practice Address - Street 1:956 KILLIAN HILL RD SW STE B
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-8977
Practice Address - Country:US
Practice Address - Phone:770-335-2434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOT MEDICAL EXAMS 4 U LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-31
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1669594479Medicaid