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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