Organization
UNIVERSITY OF SOUTH ALABAMA
Active
Other names
USA Pediatric Developmental
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN OWEN BAILEY (CEO)
(251) 471-7118
Entity
Organization
Contact information
Practice address
1601 CENTER ST STE 1S, MOBILE, AL 36604-1541
(251) 410-5437
(251) 415-8578
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 434-3626
(251) 445-2464
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
—
—
Other
Enumeration date
02/11/2016
Last updated
07/21/2022
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