Individual ProviderDooley Lafayette UnderwoodPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3200 Northline Ave, Ste 200, Greensboro, NC 27408-7616(336) 545-5000PECOS EnrollmentBased on the most recent information from CMS, provider Dooley Lafayette Underwood does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:21 AM.Profile DetailsProvider ID1225006018Provider TypeIndividualFull NameUnderwood, Dooley LafayetteCredentialPAGenderMaleSole ProprietorNoEnumeration Date3/9/2006Last Updated3/30/2011Contact InformationPractice LocationPractice Address3200 Northline Ave, Ste 200, Greensboro, NC 27408-7616Phone(336) 545-5000Fax(336) 545-5020Mailing LocationMailing AddressPO Box 38008, Greensboro, NC 27438-8008Phone(336) 545-5000Fax(336) 545-5020Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense100084North Carolina