Organization Active NPI

The Cancer Center of Southern Alabama, PA

  • Radiation Oncology Physician
  • Mobile, AL
National Provider Identifier
1295828770
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2085R0001X Issued in AL
Legal business name
THE CANCER CENTER OF SOUTHERN ALABAMA, PA
Practice address
3 Mobile Infirmary Cir Ste 306
Mobile, AL 36607-3515
Phone
(251) 544-5400
Fax
(251) 433-3122
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John R Russell, M.D.
Title
President
Phone
(251) 544-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X 2085R0001X AL Primary

Addresses

Primary practice location

3 Mobile Infirmary Cir Ste 306
Mobile, AL 36607-3515

Mailing address

PO Box 91119
Mobile, AL 36691-1119
Phone (251) 544-5400

Other identifiers 2

IdentifierTypeStateIssuer
578302580 GROUPMedicaidAL
09015791 GROUPMedicaidMS

National Provider Directory

National Provider Directory

Locations

3 Mobile Infirmary Cir
Ste 306
Mobile, AL 36607
Phone (251) 433-3122

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1295828770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91119",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366911119",
            "telephone_number": "251-544-5400",
            "fax_number": "251-433-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MOBILE INFIRMARY CIR STE 306",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073515",
            "telephone_number": "251-544-5400",
            "fax_number": "251-433-3122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CANCER CENTER OF SOUTHERN ALABAMA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "251-544-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "AL",
            "license": "2085R0001X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "578302580 GROUP",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015791 GROUP",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.