# UNIVERSITY OF SOUTH ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF SOUTH ALABAMA
- **Other names:** USA Family Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1841650017
- **Legal business name:** UNIVERSITY OF SOUTH ALABAMA
- **Authorized official:** HARVEY IKNER (ASSO ADMIN FOR AMBULATORY CLINICS)
- **Authorized official phone:** (251) 470-1671

## Contact information

- **Practice address:** 1504 SPRING HILL AVE, STE 1800, MOBILE, AL 36604-3207
- **Practice address phone:** (251) 434-3475
- **Practice address fax:** (251) 434-3837
- **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 |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2016
- **Last updated:** 03/02/2016