Organization
GLEN GABRIELSON
Active
Other names
Dothan Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN A GABRIELSON MD (PHYSICIAN/OWNER)
(334) 794-6504
Entity
Organization
Contact information
Practice address
1891 HONEYSUCKLE RD, STE 2, DOTHAN, AL 36305-4290
(334) 794-6504
(334) 793-4452
Mailing address
1891 HONEYSUCKLE RD, STE 2, DOTHAN, AL 36305-4290
(334) 794-6504
(334) 793-4452
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12449
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427210491
—
AL
Enumeration date
06/30/2008
Last updated
09/19/2008
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