MEDICARE: GLEN GABRIELSON

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
1	207Q00000X	Family Medicine Physician	12449	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427210491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLEN GABRIELSON

Provider Business Mailing Address
First Line	:	1891 HONEYSUCKLE RD
Second Line	:	STE 2
City	:	DOTHAN
State	:	AL
Zip	:	36305-4290
Country	:	US
Telephone Number	:	334-794-6504
Fax Number	:	334-793-4452

Provider Business Practice Location Address
First Line	:	1891 HONEYSUCKLE RD
Second Line	:	STE 2
City	:	DOTHAN
State	:	AL
Zip	:	36305-4290
Country	:	US
Telephone Number	:	334-794-6504
Fax Number	:	334-793-4452

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. GLEN A GABRIELSON
Credential	:	MD
Telephone Number	:	334-794-6504

Provider Enumeration Date	:	06/30/2008
Last Update Date	:	09/19/2008

Similar Medicare Providers

1861680738 — DR. TONY DOWNING GABRIELSON M.D.
Practice Location Address:

1891 HONEYSUCKLE RD , SUITE 2
DOTHAN, AL
36305-4290

Practice Phone: 334-794-6504
Practice Fax: 334-793-4452

1992122667 — MRS. ALLISON GABRIELSON DYE PA-C
Practice Location Address:

1891 HONEYSUCKLE RD , SUITE 2
DOTHAN, AL
36305-4290

Practice Phone: 334-794-6504
Practice Fax: 334-793-4452

1477180107 — DR. MARK KIRK JR.
Practice Location Address:

4370 W MAIN ST
DOTHAN, AL
36305-1056

Practice Phone: 334-793-5000
Practice Fax: 659-235-6176

1164474623 — STEPHEN BLAKELY EZZELL CRNA
Practice Location Address:

4370 W MAIN ST
DOTHAN, AL
36305-1056

Practice Phone: 334-793-5000
Practice Fax: 334-615-8419

1811450679 — DR. HOLMAN LI DO
Practice Location Address:

4370 W MAIN ST
DOTHAN, AL
36305-4000

Practice Phone: 334-793-5000
Practice Fax:

1306792288 — MS. EMILIE ANNE SANDERS FNP-C
Practice Location Address:

4370 W MAIN ST
DOTHAN, AL
36305-4000

Practice Phone: 334-699-7900
Practice Fax:

Directions to “GLEN GABRIELSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.