Organization
MCDONOUGH OBGYN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GILBERT LEE MCDONOUGH M.D. (OWNER)
(334) 347-4646
Entity
Organization
Contact information
Practice address
207 E WATTS ST, SUITE 200, ENTERPRISE, AL 36330-1801
(334) 347-4646
(334) 347-8719
Mailing address
207 E WATTS ST, SUITE 200, ENTERPRISE, AL 36330-1801
(334) 347-4646
(334) 347-8719
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3908
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04173
PROVIDER NUMBER
AL
01
—
1023077013
INDIVIDUAL NPI NUMBER
AL
01
—
510-04173
BCBS PROVIDER NUMBER
AL
Enumeration date
06/05/2007
Last updated
08/22/2020
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