Provider Demographics
NPI:1407191455
Name:CHOICE MEDICAL SOLUTIONS
Entity Type:Organization
Organization Name:CHOICE MEDICAL SOLUTIONS
Other - Org Name:ATHENS MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-262-9310
Mailing Address - Street 1:707 W MARKET ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2463
Mailing Address - Country:US
Mailing Address - Phone:256-262-9310
Mailing Address - Fax:256-262-9320
Practice Address - Street 1:707 W MARKET ST
Practice Address - Street 2:SUITE A
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2463
Practice Address - Country:US
Practice Address - Phone:256-262-9310
Practice Address - Fax:256-262-9320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL87207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty