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NPI Code Detail

MEDICARE: PHYSICIAN MANAGEMENT SERVICES OF ALABAMA LLC

MEDICARE: PHYSICIAN MANAGEMENT SERVICES OF ALABAMA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician19199AL

General Provider Information

NPI Number : 1568901742
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN MANAGEMENT SERVICES OF ALABAMA LLC
Provider Business Mailing Address
First Line : 800 N MAGNOLIA AVE STE 700
Second Line :
City : ORLANDO
State : FL
Zip : 32803-3264
Country : US
Telephone Number : 888-829-8550
Fax Number :
Provider Business Practice Location Address
First Line : 126 CLINIC DR
Second Line :
City : DOTHAN
State : AL
Zip : 36303-1980
Country : US
Telephone Number : 888-829-8550
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BRETT KENEFICK
Credential :
Telephone Number : 407-754-8723
Provider Enumeration Date : 02/21/2017
Last Update Date : 05/21/2026

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Directions to “PHYSICIAN MANAGEMENT SERVICES OF ALABAMA LLC ” Practice Location

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