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Individual

DR. STEPHEN ANTHONY KAHALLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
610 PROVIDENCE PARK DR E, BLDG 1 SUITE 102, MOBILE, AL 36695-4622
(251) 378-3900
(251) 378-3901
Mailing address
PO BOX 850489, MOBILE, AL 36685-0489
(251) 342-3949
(251) 631-3361

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00009877
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000093042
AL MEDICAID
AL
01
0410743
UNITED HEALTHCARE
AL
01
11217512
RAILROAD MEDICARE
AL
01
51093042
BCBS OF AL
AL
Enumeration date
07/27/2006
Last updated
06/03/2019
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