Healthcare Provider Details

I. General information

NPI: 1154703726
Provider Name (Legal Business Name): GULF HEALTH HOSPITALS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 MEDICAL CENTER DR
BAY MINETTE AL
36507-4163
US

IV. Provider business mailing address

2002 MEDICAL CENTER DR
BAY MINETTE AL
36507-4163
US

V. Phone/Fax

Practice location:
  • Phone: 251-937-5377
  • Fax: 251-937-5352
Mailing address:
  • Phone: 251-937-5377
  • Fax: 251-937-5352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: APRIL KAHLBAU
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 251-937-5377