Providence Medical Group

LBN: Alabama Providence Healthcare Services
Providence Medical Group is an health care organization with primary practice located at 9971 Airport Blvd , Mobile AL 36608-9525. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. Alabama Providence Healthcare Services can be contacted via phone (251) 342-3949, or through Kennedy, Todd S via phone (251) 633-8880.

Contact Information

Primary practice address
9971 Airport Blvd Mobile AL 36608-9525
Phone: (251) 342-3949
Fax: (251) 631-3361
Website:
Map and Directions
Authorized official contact:
Name: Kennedy, Todd S
Phone: (251) 633-8880

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1679932248
LBN Legal business name Alabama Providence Healthcare Services
DBA Doing business as Providence Medical Group
Authorized official Kennedy, Todd S
Entity Organization
Organization subpart 1 No
Enumeration date Feb 11th, 2016
Last updated Feb 11th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679932248 NPPES
Alabama MEDICAID 156183

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