Gulf Coast Occupational Sports and Pain Medicine LLC

Organization Active NPI Family Medicine Physician · Foley, AL

NPI 1003238569 · NPPES record last updated Dec 30, 2024

Key facts

NPI
1003238569
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
23039 (AL)
Legal business name
GULF COAST OCCUPATIONAL SPORTS AND PAIN MEDICINE LLC
Practice address
1400 N McKenzie St
Foley, AL 36535-2234
Phone
(251) 923-2050
Fax
(251) 923-2051
NPI assigned
Jan 16, 2014
Organization subpart
No

Authorized official

Name
Ron R Lee, M.D.
Title
Owner
Phone
(251) 923-2050

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140825002687 AL Part B Supplier - Clinic/Group Practice 6406074905 Receives reassigned benefits from 1 practitioner
Practice locations: Foley, AL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X 23039 AL Yes

Addresses

Primary practice location

1400 N McKenzie St
Foley, AL 36535-2234

Mailing address

1400 N McKenzie St
Foley, AL 36535-2234
Phone (251) 923-2050

Other providers in Foley, AL

All providers in Foley, AL · Family Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.