Gilbertown Family Medical Clinic

NPI 1437308921 - Family Medicine - 207Q00000X

NPI Details
NPI 1437308921
Enumeration Date 09/09/2008
Last Updated 09/09/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name WALLACE WALLACE
Position PRESIDENT
Phone (251) 843-2887
Fax
Practice Location
12731 HIGHWAY 17
GILBERTOWN AL, 36908-5229, US
Phone (251) 843-2887
Fax
Business Location
1800 12TH ST
MERIDIAN MS, 39301-4158, US
Phone (601) 703-9940
Fax (601) 703-4349
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Gilbertown Family Medical Clinic NPI is 1437308921, taxonomy code is 207Q00000X Gilbertown Family Medical Clinic physically located at 12731 Highway 17, Gilbertown AL, 36908-5229. NPI Number 1033115704 has the healthcare provider type.

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1437308921 NPI number is provided on an as is basis without warranty of any kind. 1437308921 is maintained by the National Plan & Provider Enumeration System. The contents of Gilbertown Family Medical Clinic are for informational purposes only.