Individual
DR. JIMMIE G GAVRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
188 HOSPITAL DR STE 205, FAIRHOPE, AL 36532-2038
(251) 990-9191
(251) 990-9189
Mailing address
188 HOSPITAL DR STE 205, FAIRHOPE, AL 36532-2038
(251) 990-9191
(251) 990-9189
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17506
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000092799
—
AL
01
—
92799
BCBS OF ALABAMA PROVIDER
AL
Enumeration date
12/09/2005
Last updated
11/10/2020
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