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Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Parent organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Other names
Providence Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Authorized official
MR. TODD S. KENNEDY (PRESIDENT)
(251) 633-1660
Entity
Organization
Contact information
Practice address
19140 S 3RD ST, CITRONELLE, AL 36522-2306
(251) 866-0086
(251) 866-0089
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
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
11/08/2013
Last updated
09/28/2015
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