NPI 1396846739

Uscg

Organisation Preferred Provider Organization Mobile, AL

Practice location

Address: Uscg Atc Mobile 8501 Tanner Williams Road, Mobile, AL 36608
Phone: (251) 441-6725
Mailing address: 101 Foreman Road APT C34, Mobile, AL 36608

Authorised official

Name: John Allen
Title: Medical Administrator
Phone: (251) 441-6411

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1396846739
Entity type: Organization
NPI issued: 26 Sep 2006
Record last updated: 22 Aug 2020

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.