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Dothan Pediatric Clinic, P.A.

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Details

Name: Dothan Pediatric Clinic, P.A.
Jurisdiction: Alabama
Legal type: Domestic Professional Association
Status: Exists
Date of registration: 25 Nov 1985 (40 years ago)
Entity Number: 000-006-086
Register Number: 000006086
ZIP code: 36301
City: Dothan
County: Houston
Place of Formation: Houston County
Principal Address: 2020 ALEXANDER DRIVE, DOTHAN, AL 36301
Registered Office Street Address: 126 CLINIC DRIVE, DOTHAN, AL 36303

Agent

Name Role
ROBERT J BENAK Agent

Member

Name Role Address
WILEY, JAMES C Member 3930-F AIRPORT BLVDMOBILE, AL 36608
DRIGGERS, ROY M Member No data
BARRON, WILLIAM R Member No data
LIES, WILLIAM III Member No data
BENAK, ROBERT J Member No data

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
MXE5TEWK6LW1
CAGE Code:
67BN4
UEI Expiration Date:
2025-08-13

Business Information

Activation Date:
2024-08-15
Initial Registration Date:
2010-12-02

Commercial and government entity program

The The Commercial And Government Entity Code (CAGE) is assigned by the Department of Defense's Defense Logistics Agency (DLA) and represents your company's physical address for GSA's mailings, payments, and administrative records.

Note: A CAGE Code enables a company to contract with the U.S. government, allowing bid on government contracts and to receive government payments. Also for business this means that it's a Verified business entity and Has a validated physical address.

CAGE number:
67BN4
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-06-12
CAGE Expiration:
2030-06-12
SAM Expiration:
2026-06-10

Contact Information

POC:
PRUDENCE NELSON

National Provider Identifier

NPI Number:
1457027955
Certification Date:
2021-07-22

Authorized Person:

Name:
GINA TOLAR
Role:
INSURANCE & COLLECTION SUPERVISOR
Phone:

Taxonomy:

Selected Taxonomy:
2080P0205X - Pediatric Endocrinology Physician
Is Primary:
No
Selected Taxonomy:
2080P0206X - Pediatric Gastroenterology Physician
Is Primary:
No
Selected Taxonomy:
2080P0214X - Pediatric Pulmonology Physician
Is Primary:
No
Selected Taxonomy:
2080S0012X - Pediatric Sleep Medicine Physician
Is Primary:
No
Selected Taxonomy:
2084N0402X - Neurology with Special Qualifications in Child Neurology Physician
Is Primary:
No

Contacts:

USAspending Awards / Financial Assistance

Date:
2020-04-08
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
1750289.65
Total Face Value Of Loan:
1750289.65

Paycheck Protection Program

Jobs Reported:
183
Initial Approval Amount:
$1,989,354.9
Date Approved:
2021-02-03
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,989,354.9
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$2,003,471.14
Servicing Lender:
Synovus Bank
Use of Proceeds:
Payroll: $1,989,352.9
Utilities: $1
Jobs Reported:
172
Initial Approval Amount:
$1,750,289.65
Date Approved:
2020-04-08
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,750,289.65
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$1,761,654.54
Servicing Lender:
Synovus Bank
Use of Proceeds:
Payroll: $1,750,289.65

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Date of last update: 02 Jul 2025

Sources: Alabama Secretary of State