Gulf Shores Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23373 Issued in AL

Legal business name

GULF SHORES FAMILY MEDICINE

Practice address

204 W 19TH Ave
Gulf Shores, AL 36542

Phone

(251) 968-1810

Fax

(251) 968-1817

NPI assigned

Jan 5, 2007

Last updated

Apr 2, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marirose C. Olson, M.D.

Title

President

Phone

(251) 968-1810

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1205983731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1157",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "36547",
            "telephone_number": "251-968-1810",
            "fax_number": "251-968-1817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W 19TH AVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "36542",
            "telephone_number": "251-968-1810",
            "fax_number": "251-968-1817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF SHORES FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "MARIROSE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-968-1810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "23373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9940808",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Dentistry
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• Gulf Coast Radiology Associates Inc
• Gulf Shores Dental PLLC
• Gulf Shores Emergency Physicians, LLC
• Gulf Shores Medical Center
• Gulf Shores Pediatrics PC
• Gulf Shores Pharmacy, Inc.
• Gulfview Counseling & Wellness
• Ashley Poole Hagan, CRNA

• Family Medicine Physician in Gulf Shores, AL
• Providers in Gulf Shores, AL by specialty
• Family Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.