Provider Demographics
NPI:1861680738
Name:GABRIELSON, TONY DOWNING (MD)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:DOWNING
Last Name:GABRIELSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1891 HONEYSUCKLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-4290
Mailing Address - Country:US
Mailing Address - Phone:334-794-6504
Mailing Address - Fax:334-793-4452
Practice Address - Street 1:1891 HONEYSUCKLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-4290
Practice Address - Country:US
Practice Address - Phone:334-794-6504
Practice Address - Fax:334-793-4452
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2008-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME101886207Q00000X
AL28957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1861680738Medicaid
AL51592590OtherBCBS OF ALABAMA
AL1861680738Medicaid