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Organization

USCG

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN ALLEN (MEDICAL ADMINISTRATOR)
(251) 441-6411
Entity
Organization

Contact information

Practice address
USCG ATC MOBILE, 8501 TANNER WILLIAMS ROAD, MOBILE, AL 36608
(251) 441-6725
Mailing address
101 FOREMAN ROAD APT C34, MOBILE, AL 36608
(707) 364-0116

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary

Other

Enumeration date
09/26/2006
Last updated
08/22/2020
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