Organization
UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY
Active
Organization
UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY
Active
Other names
West Mobile Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA MADISON (CREDENTIALING/ACT REP)
(251) 318-2681
Entity
Organization
Contact information
Practice address
2423 SCHILLINGER RD S, MOBILE, AL 36695-4136
(251) 660-5950
(251) 660-5949
Mailing address
3929-1 AIRPORT BLVD, 5TH FLOOR, ROOM 513, MOBILE, AL 36609
(251) 318-2681
(251) 378-6222
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
11/15/2017
Last updated
04/08/2021
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