Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
Providence Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD S. KENNEDY (PRESIDENT)
(251) 633-1660
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD, SUITE A101, 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
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RR0500X
Rheumatology Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
11/06/2013
Last updated
09/28/2015
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