Mississippi Providence Healthcare Services INC.
Family Medicine in Mobile, AL. Organization (NPI-2).
NPI number1821340407
StatusActive
Last updated in NPPESOct 8, 2012
Details
- NPI
- 1821340407
- Entity type
- Organization (NPI-2)
- Legal business name
- Mississippi Providence Healthcare Services INC.
- Organization subpart
- No
- Enumeration date
- Oct 8, 2012
- Last updated
- Oct 8, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
6701 Airport BlvdSuite D430
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
Clark P. Christianson
President
2516331660
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