Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
The Cancer Center at Providence Park PET CT
Organization subpart
No
Provider details
NPI number
Authorized official
TODD KENNEDY (PRESIDENT)
(251) 633-1000
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD, SUITE A-T01, MOBILE, AL 36608-6705
(251) 633-1890
Mailing address
PO BOX 850489, MOBILE, AL 36685-0489
(251) 342-3949
(251) 631-3361
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156183
—
AL
Enumeration date
04/06/2016
Last updated
04/06/2016
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