Organization
UNIVERSITY OF SOUTH ALABAMA HEALTH SERVICES FOUNDATION
Active
Other names
USA Stanton Road Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY S. TATE (CHIEF EXECUTIVE OFFICER)
(251) 470-5842
Entity
Organization
Contact information
Practice address
575 STANTON RD, MOBILE, AL 36617-2344
(251) 471-7207
(251) 471-7468
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 470-5842
(251) 470-5809
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09013348
—
MS
05
—
528500370
—
AL
Enumeration date
12/13/2006
Last updated
11/27/2013
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