Individual
MICHAEL WAYNE PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD,FAAFP
Contact information
Practice address
1325 QUINTARD AVE, ANNISTON, AL 36201-4619
(256) 741-1339
(256) 741-1356
Mailing address
1325 QUINTARD AVE, ANNISTON, AL 36201-4619
(256) 741-1339
(256) 741-1356
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00011525
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51509348
BLUE CROSS BLUE SHIELD
AL
Enumeration date
12/18/2006
Last updated
07/08/2007
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