# UNIVERSITY OF SOUTH ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF SOUTH ALABAMA
- **Other names:** University of South Alabama Anesthesia
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417408659
- **Legal business name:** UNIVERSITY OF SOUTH ALABAMA
- **Authorized official:** OWEN BAILEY (CHIEF OPERATING OFFICER)
- **Authorized official phone:** (251) 471-7110

## Contact information

- **Practice address:** 2451 FILLINGIM ST, MOBILE, AL 36617-2238
- **Practice address phone:** (251) 471-7000
- **Mailing address:** PO BOX 40010, MOBILE, AL 36640-0010
- **Mailing address phone:** (251) 434-3505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 10/24/2016
- **Last updated:** 10/24/2016