Alabama Providence Healthcare Services
Family Medicine in Mobile, AL. Organization (NPI-2).
NPI number1093144180
StatusActive
Last updated in NPPESSep 28, 2015
Details
- NPI
- 1093144180
- Entity type
- Organization (NPI-2)
- Legal business name
- Alabama Providence Healthcare Services
- Organization subpart
- Yes
- Enumeration date
- Nov 8, 2013
- Last updated
- Sep 28, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Providence Medical Group (Other Name)
Practice location
8833 Cottage Hill RdMobile, AL 36695-8345
Phone 251-544-5420 · Fax 251-544-5425
Mailing address
Po Box 850489Mobile, AL 36685-0489
Phone 251-342-3949 · Fax 251-631-3361
Authorized official
Todd S. Kennedy
President
2516331660
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