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General NPI Number Information
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NPI Number | 1417020322
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Entity Type | Individual
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Provider Name | MADELINE FAY FERRELL M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 114 E TROY ST
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City | DOTHAN
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State | AL
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Zip | 36303-4844
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Country | US
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Telephone | 334-671-5577
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Fax | 334-673-7247
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Provider Business Mailing Address
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Address Line | 114 E TROY ST
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City | DOTHAN
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State | AL
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Zip | 36303-4844
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Country | US
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Telephone | 334-671-5577
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Fax | 334-673-7247
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 19045
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License Number State | AL
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