Alabama Providence Healthcare Services
Family Medicine in Mobile, AL. Organization (NPI-2).
NPI number1447799861
StatusActive
Last updated in NPPESMay 9, 2017
Details
- NPI
- 1447799861
- Entity type
- Organization (NPI-2)
- Legal business name
- Alabama Providence Healthcare Services
- Organization subpart
- No
- Enumeration date
- Feb 17, 2017
- Last updated
- May 9, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Providence Medical Group (Doing Business As)
Practice location
5621 Cottage Hill RdMobile, AL 36609-4210
Phone 251-666-2439 · Fax 251-666-3166
Mailing address
Po Box 850489Mobile, AL 36685-0489
Phone 251-342-3949 · Fax 251-631-3361
Authorized official
Erica Madison
Credentialing Specialist
2513423949
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