Gabrielson, Glen A
Gabrielson, Glen A is an sole proprietor health care provider with primary practice located at 1891 Honeysuckle Rd Ste C2, Dothan AL 36305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gabrielson, Glen A can be contacted via phone (334) 794-6504.Contact Information
Primary practice address
1891 Honeysuckle Rd Ste C2
Dothan AL 36305
Phone: (334) 794-6504
Fax: (334) 793-4452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 00012449 | Alabama |
Profile Details
| NPI number | 1912956590 |
|---|---|
| LBN Legal business name | Gabrielson, Glen A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 9th, 2006 |
| Last updated | May 15th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912956590 | NPPES |
| Alabama | MEDICAID | 000015369 | |
| Alabama | Other | 51523143 |
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