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Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
Providence Medical Group - Fairhope
Organization subpart
No
Provider details
NPI number
Authorized official
TODD KENNEDY (PRESIDENT)
(251) 633-1000
Entity
Organization
Contact information
Practice address
411 N SECTION ST, FAIRHOPE, AL 36532-2649
(251) 342-3949
Mailing address
PO BOX 850489, MOBILE, AL 36685-0489
(251) 342-3949
(251) 631-3361
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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