# IMC-EASTERN SHORE FAMILY PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235659319
- **Authorized official:** PHILLIP L COWART (VP FINANCE)
- **Authorized official phone:** (251) 435-1361

## Contact information

- **Practice address:** 27961 HIGHWAY 98, SUITE 14, DAPHNE, AL 36526
- **Practice address phone:** (251) 626-1175
- **Practice address fax:** (251) 626-1507
- **Mailing address:** PO BOX 2226, MOBILE, AL 36652-2226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/21/2017
- **Last updated:** 07/24/2026