# UNIVERSITY OF SOUTH ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** USA Medical Genetics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487015962
- **Authorized official:** GLEN OWEN BAILEY (ASSO ADMIN OF AMBULATORY CLINICS)
- **Authorized official phone:** (251) 471-7118

## Contact information

- **Practice address:** 1601 CENTER ST STE 1S, MOBILE, AL 36604-1541
- **Practice address phone:** (251) 410-5437
- **Practice address fax:** (251) 415-8562
- **Mailing address:** PO BOX 40480, MOBILE, AL 36640-0480
- **Mailing address phone:** (251) 434-3626
- **Mailing address fax:** (251) 445-2464

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | NULL | Yes |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/11/2016
- **Last updated:** 07/21/2022