Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
Providence Medical Group - ENT
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA MADISON (CREDENTIALING SPECIALIST)
(251) 342-3949
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD, SUITE B123, MOBILE, AL 36608-6705
(251) 342-3949
(251) 631-3361
Mailing address
PO BOX 850489, MOBILE, AL 36685-0489
(251) 342-3949
(251) 631-3361
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
05/03/2017
Last updated
05/03/2017
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