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Providence Healthcare Services

Internal Medicine in Mobile, AL. Organization (NPI-2).

NPI number1497959613
StatusActive
Last updated in NPPESMay 9, 2017

Details

NPI
1497959613
Entity type
Organization (NPI-2)
Legal business name
Providence Healthcare Services
Organization subpart
No
Enumeration date
Jun 12, 2007
Last updated
May 9, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Other names

  • Providence Medical Group (Doing Business As)

Practice location

5621 Cottage Hill Rd
Mobile, AL 36609-4210

Phone 251-666-2439 · Fax 251-666-3166

Mailing address

Po Box 850489
Mobile, AL 36685-0489

Phone 251-342-3949 · Fax 251-631-3361

Authorized official

Todd Kennedy
President
2516313574

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