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Organization

UNIVERSITY OF SOUTH ALABAMA

Active
Parent organization
UNIVERSITY OF SOUTH ALABAMA
Other names
USA Nephrology- Adult
Organization subpart
Yes

Provider details

NPI number
Legal business name
UNIVERSITY OF SOUTH ALABAMA
Authorized official
HARVEY IKNER (ASSO ADMIN OF AMBULATORY CLINICS)
(251) 470-1671
Entity
Organization

Contact information

Practice address
2451 FILLINGIM ST, MSTN BLDG., MOBILE, AL 36617-2238
(251) 470-5890
(251) 471-7925
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 434-3626
(251) 445-2464

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Enumeration date
02/24/2016
Last updated
02/24/2016
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