| Dothan Family Practice | |
|
1891 Honeysuckle Rd Ste 2 Dothan AL 36305-4290 | |
| (334) 794-6504 | |
| (334) 793-4452 |
| Full Name | Dothan Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1891 Honeysuckle Rd, Dothan, Alabama |
| Authorized Official Name and Position | Glen A Gabrielson (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3347946504 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dothan Family Practice 1891 Honeysuckle Rd Ste 2 Dothan AL 36305-4290 Ph: (334) 794-6504 | Dothan Family Practice 1891 Honeysuckle Rd Ste 2 Dothan AL 36305-4290 Ph: (334) 794-6504 |
| NPI Number | 1427210491 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 09/19/2008 |
| Medicare PECOS PAC ID | 6709950264 |
|---|---|
| Medicare Enrollment ID | O20080731000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427210491 | NPI | - | NPPES |
| 1427210491 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 12449 (Alabama) | Primary |
| Provider Name | Glen A Gabrielson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912956590 PECOS PAC ID: 6608844758 Enrollment ID: I20040917000287 |
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