Provider Demographics
NPI:1285794537
Name:GABLES, KEN P (MSPT)
Entity type:Individual
Prefix:MR
First Name:KEN
Middle Name:P
Last Name:GABLES
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 KRISTI CIR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5832
Mailing Address - Country:US
Mailing Address - Phone:205-298-9403
Mailing Address - Fax:
Practice Address - Street 1:2200 RIVERCHASE CTR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35244-2866
Practice Address - Country:US
Practice Address - Phone:205-739-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH2383OtherPHYSICAL THERAPY LICENSE