Organization
SANSARICQ OB/GYN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA JADICK (CREDENTIALING)
(251) 479-0058
Entity
Organization
Contact information
Practice address
524 STANTON RD, MOBILE, AL 36617-2343
(251) 479-0058
(251) 479-1585
Mailing address
524 STANTON RD, MOBILE, AL 36617-2343
(251) 479-0058
(251) 479-1585
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
17868
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340735
—
AL
Enumeration date
12/06/2007
Last updated
06/25/2025
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