Organization
ALABAMA PROVIDENCE HEALTHCARE SERVICES
Active
Other names
The Cancer Center at Providence Park PET CT
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA MADISON (CREDENTIALING SPECIALIST)
(251) 342-3949
Entity
Organization
Contact information
Practice address
6701 AIRPORT BLVD, SUITE D143, MOBILE, AL 36608-6705
(251) 342-3949
(251) 631-3361
Mailing address
6701 AIRPORT BLVD, SUITE A-T01, MOBILE, AL 36608-6705
(251) 342-3949
(251) 631-3361
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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