Healthcare Provider Details

I. General information

NPI: 1053105114
Provider Name (Legal Business Name): GCMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7540 CIPRIANO CT STE B
FAIRHOPE AL
36532-3029
US

IV. Provider business mailing address

PO BOX 277
MONTROSE AL
36559-0277
US

V. Phone/Fax

Practice location:
  • Phone: 251-308-6647
  • Fax: 251-308-1656
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: HOYT HARRIS REYNOLDS
Title or Position: PRESIDENT
Credential: MD
Phone: 251-308-6647