# UNIVERSITY OF SOUTH ALABAMA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** UNIVERSITY OF SOUTH ALABAMA
- **Other names:** USA Infectious Disease - Adult
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962862656
- **Legal business name:** UNIVERSITY OF SOUTH ALABAMA
- **Authorized official:** HARVEY IKNER (ASSO ADMIN OF AMBULATORY CLINICS)
- **Authorized official phone:** (251) 470-1671

## Contact information

- **Practice address:** 2451 FILLINGIM ST, MSTN BLDG, MOBILE, AL 36617-2238
- **Practice address phone:** (251) 470-5890
- **Practice address fax:** (251) 471-7925
- **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 |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | — | NULL | Yes |
| 207RI0200X | Infectious Disease Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2016
- **Last updated:** 03/17/2016