Alabama Providence Healthcare Services
Internal Medicine in Mobile, AL. Organization (NPI-2).
NPI number1245669514
StatusActive
Last updated in NPPESSep 28, 2015
Details
- NPI
- 1245669514
- Entity type
- Organization (NPI-2)
- Legal business name
- Alabama Providence Healthcare Services
- Organization subpart
- No
- Enumeration date
- Nov 6, 2013
- Last updated
- Sep 28, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 207RE0101X | Internal Medicine, Endocrinology, Diabetes & Metabolism | – | – | |
| 207RG0100X | Internal Medicine, Gastroenterology | – | – | |
| 207RR0500X | Internal Medicine, Rheumatology | – | – | |
| 208D00000X | General Practice | – | – |
Other names
- Providence Medical Group (Doing Business As)
Practice location
6701 Airport BlvdSuite A101
Mobile, AL 36608-6705
Phone 251-342-3949 · Fax 251-631-3361
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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