NPI 1124222427

Providence Healthcare Services

Organisation Family Medicine Physician Mobile, AL

Practice location

Address: 5100 Rangeline Road North, Mobile, AL 36619-9504
Phone: (251) 661-4454
Fax: (251) 661-9843
Mailing address: PO Box 850489, Mobile, AL 36685-0489

Authorised official

Name: Clark P. Christianson
Title: President
Phone: (251) 633-1660

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Alabama →

Registry record

NPI: 1124222427
Entity type: Organization
NPI issued: 12 Jun 2007
Record last updated: 13 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.