| Dothan Family Practice | |
|
1891 Honeysuckle Rd Ste 2a Dothan AL 36305-4291 | |
| (334) 794-6504 | |
| (334) 793-4452 |
| Full Name | Dothan Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1891 Honeysuckle Rd Ste 2a, Dothan, Alabama |
| Authorized Official Name and Position | Nidal Yunis (OWNER) |
| Authorized Official Contact | 3346996396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dothan Family Practice Po Box 242848 Montgomery AL 36124-2848 Ph: (800) 334-1757 | Dothan Family Practice 1891 Honeysuckle Rd Ste 2a Dothan AL 36305-4291 Ph: (334) 794-6504 |
| NPI Number | 1003403569 |
|---|---|
| Provider Enumeration Date | 12/30/2020 |
| Last Update Date | 01/11/2021 |
| Medicare PECOS PAC ID | 7214346303 |
|---|---|
| Medicare Enrollment ID | O20210430001055 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003403569 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Glen A Gabrielson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912956590 PECOS PAC ID: 6608844758 Enrollment ID: I20040917000287 |
| Provider Name | Valerie W Cobb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720232333 PECOS PAC ID: 1557427556 Enrollment ID: I20090226000449 |
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