Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
Providence Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD S. KENNEDY (PRESIDENT)
(251) 633-1660
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD, SUITE A107, MOBILE, AL 36608-6705
(251) 633-8880
(251) 633-2817
Mailing address
PO BOX 850489, MOBILE, AL 36685-0489
(251) 342-3949
(251) 631-3361
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156183
—
AL
Enumeration date
06/24/2014
Last updated
09/28/2015
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