Organization
SPRINGHILL DERMATOLOGY CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BELEN FRED BODIE MD (OWNER)
(251) 342-7880
Entity
Organization
Contact information
Practice address
4300 OLD SHELL RD STE B, MOBILE, AL 36608-2036
(251) 342-7880
(251) 342-8369
Mailing address
4300 OLD SHELL RD STE B, MOBILE, AL 36608-2036
(251) 342-7880
(251) 342-8369
Taxonomy
Speciality
Code
Description
License number
State
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
Primary
6998
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51004869
BLUE CROSS AND BLUE SHIELD
AL
01
—
CG4447
MEDICARE RAILROAD
AL
Enumeration date
07/20/2007
Last updated
07/08/2008
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