Organization
THE CANCER CENTER OF SOUTHERN ALABAMA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R RUSSELL M.D. (PRESIDENT)
(251) 544-5400
Entity
Organization
Contact information
Practice address
3 MOBILE INFIRMARY CIR STE 306, MOBILE, AL 36607-3515
(251) 544-5400
(251) 433-3122
Mailing address
PO BOX 91119, MOBILE, AL 36691-1119
(251) 544-5400
(251) 433-3122
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2085R0001X
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015791 GROUP
—
MS
05
—
578302580 GROUP
—
AL
Enumeration date
10/02/2006
Last updated
08/25/2008
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