# RAYNARD FABIANKE, MEDICAL CLINIC OF RED BAY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770666992
- **Authorized official:** MONICA COPELAND (BILLING MANAGER)
- **Authorized official phone:** (256) 532-1888

## Contact information

- **Practice address:** 209 HOSPITAL RD, RED BAY, AL 35582-3858
- **Practice address phone:** (256) 356-9511
- **Practice address fax:** (256) 356-9339
- **Mailing address:** PO BOX 429, RED BAY, AL 35582-0429
- **Mailing address phone:** (256) 356-9511
- **Mailing address fax:** (256) 356-9339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 09/30/2013