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Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
Providence Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA MADISON (CREDENTIALING SPECIALIST)
(251) 342-3949
Entity
Organization
Contact information
Practice address
5621 COTTAGE HILL RD, MOBILE, AL 36609-4210
(251) 666-2439
(251) 666-3166
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
02/17/2017
Last updated
05/09/2017
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