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Organization
COASTAL ANESTHESIA, P.C.
Active
Organization
COASTAL ANESTHESIA, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL C BOUDREAUX MD (PRESIDENT)
(251) 342-3000
Entity
Organization
Contact information
Practice address
3719 DAUPHIN ST, SPRINGHILL MEDICAL CENTER ANESTHESIA DEPT, MOBILE, AL 36608-1753
(251) 342-3000
(251) 342-3043
Mailing address
PO BOX 851417, MOBILE, AL 36685-1417
(251) 342-3000
(251) 342-3043
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0216
MEDICARE TRAVELERS
AL
Enumeration date
02/13/2006
Last updated
03/18/2008
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