Provider Demographics
NPI:1790175776
Name:MEDICAL WELLNESS SOLUTIONS, INC
Entity Type:Organization
Organization Name:MEDICAL WELLNESS SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-209-2122
Mailing Address - Street 1:7956 VAUGHN RD
Mailing Address - Street 2:#165
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-6625
Mailing Address - Country:US
Mailing Address - Phone:334-209-2122
Mailing Address - Fax:
Practice Address - Street 1:1100 S COLLEGE ST
Practice Address - Street 2:108C
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36832-5899
Practice Address - Country:US
Practice Address - Phone:334-209-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty