STATE EMPLOYEE INJURY COMPENSATION TRUST FUND SEICTF PREFERRED PROVIDER NETWORK by theredman

VIEWS: 29 PAGES: 9

									       STATE EMPLOYEE INJURY COMPENSATION TRUST FUND (SEICTF)
                 PREFERRED PROVIDER NETWORK (PPN)
            PRIMARY CARE PHYSICIAN LISTING (GATEKEEPERS)

                             EFFECTIVE: 5-13-05
Name of County   Name of Physician                  Telephone
                                                    Number
AUTAUGA          Dr. James Robert Carpenter         (334) 365-5987
                 645 McQueen Smith Road N Ste 101
                 Prattville 36066
BALDWIN          Dr. Robert L. Ross, III            (251) 625-8222
                 IMC-Industrial Medical Clinic
                 7101 Hwy 90 Ste 101
                 Daphne 36526
BALDWIN          Dr. Cynthia S. Harbaugh            (251) 981-2377
                 Gulf Coast Convenient Care
                 3099 Loop Road
                 Orange Beach 36561
BALDWIN          Dr. Gary E. Kolb                   (251) 937-5652
                 Bay Minette Family Practice
                 2305 Hand Avenue
                 Bay Minette 36507
BALDWIN          Dr. Lynn E. Yonge                  (251) 990-8860
                 405 N Section Street
                 Fairhope 36532

BARBOUR          Dr. Richard Shack                  (334) 687-0112
                 Eufaula Family Medicine
                 617 E Broad Street Ste B
                 Eufaula 36027
BIBB             See adjacent county

BLOUNT           Dr. John E. Smith                  (205) 274-8198
                 Dr. David R. Wilson
                 Baptist Health Blount
                 203 Shirley Street
                 Oneonta 35121
BULLOCK          See adjacent county


                                Page 1 of 9
Name of County   Name of Physician                     Telephone
                                                       Number
BUTLER           Dr. Danny Trammell Hood               (334) 382-6864
                 Street: 45 Medical Arts Court Ste 4
                 Mailing: PO Box 398
                 Greenville 36037
CALHOUN          Dr. Neal D. Van Marter                (256) 236-6411
                 Family & Occupational Medicine
                 3320 Henry Road
                 Anniston 36207
CHAMBERS         Dr. Eric J. Hemberg                   (334) 756-4136
                 14 Medical Park
                 Valley 36854
CHEROKEE         See adjacent county
CHILTON          Dr. Charles Keith Funderburk          (205) 755-5700
                 108 Medical Center Drive
                 Clanton 35045
CHOCTAW          See adjacent county
CLARKE           Dr. Steven P. Furr                    (251) 246-4446
                 IMC Family Medicine
                 Street:      226 Hospital Drive
                 Mailing:     PO Box 639
                 Jackson 36545
CLAY             See adjacent county
CLEBURNE         See adjacent county
COFFEE           Dr. William Reynolds, Jr              (334) 347-3404
                 101 Professional Lane
                 Enterprise 36330
COLBERT          Dr. Christopher P. Gay                (256) 314-1499
                 1111 South Jackson Hwy
                 Sheffield 35660
CONECUH          See adjacent county
COOSA            See adjacent county
COVINGTON        Dr. Steven J. Davis, Sr               (334) 493-3240
                 511 Brantley Street
                 Opp 36467
CRENSHAW         Dr. Charles Samuel Tompkins           (334) 335-3383
                 1704 South Forest Avenue


                                Page 2 of 9
Name of County   Name of Physician                     Telephone
                                                       Number
                 Luverne 36049
CULLMAN          See adjacent county
DALE             Dr. Robert J. Kreutzmann              (334) 774-7572
                 359 James Street
                 Ozark 36360
DALLAS           UAB Selma Family Medicine Residency   (334) 875-4184
                 Program
                 1023 Medical Ctr Parkway Ste 200
                 Selma 36701
DEKALB           Dr. Timothy B. Decker                 (256) 638-1100
                 Decker Clinic
                 Street:      511 Main Street West
                 Mailing:     PO Box 1049
                 Rainsville 35986
ELMORE           Dr. James F. Mracek, II               (334) 514-2002
                 807 Jackson Trace
                 Wetumpka 36092
ESCAMBIA         Dr. Mark E. Robinson                  (251) 809-3208
                 Brewton Medical Center
                 Street:      1121 Bellville Avenue
                 Mailing:     PO Box 648
                 Brewton 36426
ETOWAH           Dr. Michael K. Morris                 (256) 547-6522
                 Riverview Physical Medicine
                 200-E West Meighan Blvd
                 Gadsden 35901
FAYETTE          Dr. Jon E. Sanford                    (205) 932-3900
                 122 17th Court NE
                 Fayette 35555
FRANKLIN         See adjacent county
GENEVA           Dr. David H. Arnold                   (334) 684-2281
                 3 West Lake Professional Park
                 Geneva 36340
GREENE           See adjacent county
HALE             See adjacent county
HENRY            Dr. Richard V. Meadows                (334) 585-6421

                                 Page 3 of 9
Name of County   Name of Physician                    Telephone
                                                      Number
                 Family Practice Center
                 217 Dothan Road
                 Abbeville 36310
HOUSTON          See adjacent county
JACKSON          Dr. James W. Johnt                   (256) 218-3860
                 Occupational Medicine Services
                 380 Woods Cove Road
                 Scottsboro 35768
JEFFERSON        Dr. Matthew Berke                    (205) 838-3090
                 Orthopedic Specialists of Alabama
                 48 Medical Park East Drive Ste 225
                 Birmingham 35435
JEFFERSON        Dr. Michael Lee Cloyd                (205) 930-2910
                 St. Vincents Occ Health Clinic
                 1 Lakeshore Dr Ste 301
                 Birmingham 35209
JEFFERSON        Dr. J. Michael Grabowski             (205) 930-7320
                 AlaComp
                 1222 14th Avenue S Ste 101
                 Birmingham 35205
JEFFERSON        Dr. Timothy J. Key                   (205) 930-8460
                 Dr. Michael Mueller
                 WORK WISE - BIRMINGHAM
                 1201 11th Ave S Ste 100
                 Birmingham 35205
JEFFERSON        Dr. Timothy J. Key                   (205) 425-0218
                 Dr. Michael Mueller
                 WORK WISE – WEST
                 709 Memorial Drive
                 Bessemer 35022
LAMAR            Dr. R. William Davis                 (205) 698-7111
                 Lamar Reg. Health Ctr
                 49494 Hwy 17
                 Sulligent 3556
LAUDERDALE       Dr. Gary W. Daniel                   (256) 760-1977
                 Occupational Health Center


                                Page 4 of 9
Name of County   Name of Physician                       Telephone
                                                         Number
                 1949 Florence Blvd
                 Florence 35630
LAUDERDALE       Dr. David A. Hollis                     (256) 757-5353
                 Killen Clinic
                 148 J. C. Mauldin Highway
                 Killen 35645
LAWRENCE         Dr. Samuel Nixon Gillespie              (256) 974-9216
                 Complete Family Care
                 94 Medical Park
                 Moulton 35650
LEE              Dr. John Garth Stauffer                 (334) 821-7788
                 Alabama Occupational Medicine
                 2515 E Glenn Avenue Ste 306
                 Auburn 36831
LIMESTONE        See adjacent county
LOWNDES          See adjacent county
MACON            Dr. Robert H. Story                     (334) 727-7628
                 Tuskegee Medical & Surgical Center
                 802 Crawford Street
                 Tuskegee 36083
MADISON          Dr. James F. Gauthier                   (256) 265-7000
                 Dr. Joseph L. Rea
                 Occupational Health Group
                 OHG of Huntsville
                 1963 Memorial Parkway Ste 24
                 Huntsville 35801
MADISON          Dr. Susie W. Lynn                       (256) 774-7300
                 Occupational Health Group
                 OHG of Madison
                 Meadow Green Center
                 9238 Madison Boulevard Bldg 1 Ste 200
                 Madison 35758

MARENGO          Dr. Paul Franklin Ketcham               (334) 289-0499
                 Street:      202 Hwy 80 East
                 Mailing:     P.O. Box 650
                 Demopolis 36732

                                Page 5 of 9
Name of County   Name of Physician                             Telephone
                                                               Number
MARION           See adjacent county
MARSHALL         Dr. Lezlie T. Reed-Johnson                    (256) 582-5131
                 Lakeside Clinic LLC
                 2337 Homer Clayton Drive
                 Guntersville 35976
MOBILE           Dr. John L. Dixon                             (251) 675-4733
                 Occupational Health Networks
                 Northside Clinic
                 1020 Cleveland Road
                 Saraland 36571
MOBILE           Dr. John Hamilton                             (251) 433-3781
                 Industrial Medical Clinic
                 305 N Water Street
                 Mobile 36602
MONROE           Dr. Albert Boroughs                           (251) 575-4825
                 Doctors Clinic of Monroeville
                 1772 S Alabama Avenue
                 Monroeville 36460
MONTGOMERY       Dr. Michael Turner                            (334)261-4445
                 Southeastern Industrial & Family Med. Assoc
                 1600 Forest Avenue
                 Montgomery 36106
MONTGOMERY       Dr. Norman A. Garrison                        (334) 260-5111
                 Industrial Health Services, IIC
                 433 St. Lukes Drive
                 Montgomery 36117
MONTGOMERY       Dr. E. Arnold Johnson                         (334) 262-2602
                 Tri-County Industrial Med Spec
                 1758 Park Place Ste 105
                 Montgomery 36106
MORGAN           Dr. Freddie McMurry                           (256) 353-4325
                 Dr. R. Michael Lowery
                 Occupational Health Group
                 OHG of Decatur
                 Street:      1615 Kathy Lane SW
                 Mailing:     P.O. Box 2240
                 Decatur 35609-2240

                                 Page 6 of 9
Name of County   Name of Physician                            Telephone
                                                              Number
PERRY            Dr. William Shane Lee                        (334) 683-9085
                 Marion Clinic
                 Highway 45 South, RR II, Box 4-D
                 Marion 36756-9261
PICKENS          Dr. Harry L. Richardson                      (205) 375-6251
                 Reform Medical Clinic
                 Street:         514 10th Ave SW
                 Mailing:        PO Box 670
                 Reform 35481
PIKE             Dr. Todd Barry Pearlstein                    (334) 566-9800
                 Southern Health Associates
                 Street:        801 South Franklin
                 Mailing:      P O Box 1185
                 Troy 36081
RANDOLPH         Dr. Mitchell C. Shirah                       (334) 863-8951
                 Street:         4441 Hwy 431 N Ste 1
                 Mailing:       PO Box 1397
                 Roanoke 36274
RUSSELL          Dr. Gary Amon Dillard                        (334) 291-8303
                 Chattahoochee Valley Family Physicians LLC
                 1810 Stadium Drive Ste 240
                 Phenix City 36867
SHELBY           Dr. Harvey S. Harmon                         (205) 995-2520
                 Double Oak Family Medicine
                 101 Missionary Ridge Ste 100
                 Birmingham 35242
SUMTER           Dr. William Russ Simpkins                    (205) 652-2686
                 Livingston Clinic
                 Highway 11 North
                 Livingston 35470
TALLADEGA        Dr. Stanley Wayne Jett                       (205) 763-7848
                 BHC Lincoln Clinic
                 47344 US Hwy 78
                 Lincoln 35096
TALLAPOOSA       Dr. John Martin James                        (256) 234-4131
                 Street:     44 Aliant Parkway
                 Mailing:    PO Box 789

                                 Page 7 of 9
Name of County   Name of Physician                          Telephone
                                                            Number
                 Alexander City 35010
TALLAPOOSA       Dr. Robert A. Schuster                     (256) 825-7871
                 Lakes Martin Family Medicine
                 Street:      301 Mariarden Road, Suite D
                 Mailing:     PO Box 129
                 Dadeville 36853
TUSCALOOSA       Dr. Peter Casten                           (205) 333-4300
                 DCH Center for Occupational Health
                 DCH Medical Tower One
                 701 University Blvd E Ste 211
                 Tuscaloosa 35401
TUSCALOOSA       Dr. Douglas S. Reynolds                    (205) 345-6960
                 University Family Practice
                 904 Anna Avenue
                 Tuscaloosa 35401
WALKER           Dr. Mark S. Keating                        (205) 384-9004
                 Dr. Woodrow (Woody) W. Herring, III
                 Family Health Associates, PC
                 801 20th Avenue East
                 Jasper 35501
WASHINGTON       See adjacent county
WILCOX           Dr. Sumpter Dudley Blackmon                (334) 682-4128
                 Street:     321 Whiskey Run Road
                 Mailing:    PO BOX 699
                 Camden 36726
WINSTON          Dr. Mark S. Keating                        (205) 489-3240
                 Dr. Woodrow (Woody) Herring, III           or
                 Family Health Associates, PC               (205) 384-9004
                 25734 Highway 195
                 Double Springs 35553
WINSTON          Dr. Boyde J. Harrison                      (205) 486-5234
                 Street:       904 26th Street
                 Mailing:      PO Box 655
                 Haleyville 35565




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