Organization
THE UNIVERSITY OF SOUTH ALABAMA FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENETTA DENISE MACMILLAN RN (MANAGER CLINICAL OPERATION)
(251) 434-3661
Entity
Organization
Contact information
Practice address
1504 SPRING HILL AVE, 1800, MOBILE, AL 36604-3207
(251) 434-3661
Mailing address
3804 CABANA SQ, 204, MOBILE, AL 36609-7610
(205) 523-1208
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2530
AL
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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