Organization
UNIVERSITY OF SOUTH ALABAMA
Active
Other names
USA Student Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY KELLEN (PRACTICE DIRECTOR)
(251) 460-7681
Entity
Organization
Contact information
Practice address
5870 ALUMNI CIR, MOBILE, AL 36688-0001
(251) 460-7151
(251) 414-8227
Mailing address
5870 ALUMNI CIR, MOBILE, AL 36688-0001
(251) 460-7151
(251) 414-8227
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
529928530
—
AL
01
—
W531
BCBS
AL
Enumeration date
06/10/2006
Last updated
08/23/2016
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