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 1:2020 CANYON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1959
Mailing Address - Country:US
Mailing Address - Phone:205-877-9191
Mailing Address - Fax:205-877-8377
Practice Address - Street 1:2020 CANYON RD STE 200
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1959
Practice Address - Country:US
Practice Address - Phone:205-877-9191
Practice Address - Fax:205-877-8377
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.656363A00000X
363AS0400X
ALPA656363AS0400X
AL9262255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer