Organization
IMC-EASTERN SHORE FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY PALAZZO (VICE PRESIDENT OF FINANCE)
(251) 435-1361
Entity
Organization
Contact information
Practice address
27961 HIGHWAY 98, SUITE 14, DAPHNE, AL 36526
(251) 626-1175
(251) 626-1507
Mailing address
PO BOX 2226, MOBILE, AL 36652-2226
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/21/2017
Last updated
06/21/2017
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