Provider Demographics
NPI:1417903535
Name:RHAME, GARY LYNN (DO)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:LYNN
Last Name:RHAME
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 840
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-0840
Mailing Address - Country:US
Mailing Address - Phone:205-333-8800
Mailing Address - Fax:205-333-8406
Practice Address - Street 1:1325 MCFARLAND BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3270
Practice Address - Country:US
Practice Address - Phone:205-333-8800
Practice Address - Fax:205-333-8406
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6266207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00380409OtherRAILROAD MEDICARE
AL009936599Medicaid
AL051557495Medicare ID - Type Unspecified
P00380409OtherRAILROAD MEDICARE
AL009936599Medicaid