Organization
PHYSICIAN MANAGEMENT SERVICES OF ALABAMA LLC
Active
Parent organization
VAXCARE CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
VAXCARE CORPORATION
Authorized official
BRETT KENEFICK (PRESIDENT)
(407) 754-8723
Entity
Organization
Contact information
Practice address
126 CLINIC DR, DOTHAN, AL 36303-1980
(888) 829-8550
Mailing address
3113 LAWTON RD, SUITE 250, ORLANDO, FL 32803-3531
(888) 829-8550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19199
AL
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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