Healthcare Provider Details

I. General information

NPI: 1134117591
Provider Name (Legal Business Name): GURINDER J DOAD MD,PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5462 TAMMY LITTLE DR
SECTION AL
35771-7208
US

IV. Provider business mailing address

PO BOX 320
SECTION AL
35771-0320
US

V. Phone/Fax

Practice location:
  • Phone: 256-228-4166
  • Fax: 256-228-4186
Mailing address:
  • Phone: 256-228-4166
  • Fax: 256-228-4186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21721
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: