Organization
COASTAL SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA DARLENE CHARLTON (ADMINISTRATOR)
(251) 970-1948
Entity
Organization
Contact information
Practice address
1668 N PINE ST, FOLEY, AL 36535-2220
(251) 970-1948
(251) 970-1593
Mailing address
PO BOX 2065, 1668 NORTH PINE STREET, FOLEY, AL 36536-2065
(251) 970-1948
(251) 970-1593
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000026690
—
AL
05
—
000099973
—
AL
01
—
1275506917
NPI
AL
01
—
1306842570
NPI
AL
01
—
1730153271
NPI
—
01
—
51002338
BCBS AL
AL
01
—
51026690
BCBS AL
AL
01
—
51099973
BCBS AL
AL
05
—
529925730
—
AL
Enumeration date
01/18/2008
Last updated
03/10/2011
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