Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
Providence Medical Group - Gulf Shores
Organization subpart
No
Provider details
NPI number
Authorized official
TODD KENNEDY (PRESIDENT)
(251) 633-8880
Entity
Organization
Contact information
Practice address
1700 W 2ND ST, GULF SHORES, AL 36542-3422
(251) 342-3949
(251) 631-3361
Mailing address
6701 AIRPORT BLVD, SUITE 143, MOBILE, AL 36608-6705
(251) 342-3949
(251) 631-3361
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156183
—
AL
Enumeration date
02/16/2016
Last updated
02/16/2016
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