Alabama Providence Healthcare Services
Organization Active NPI Family Medicine Physician · Fairhope, AL
NPI 1316464183 · NPPES record last updated Aug 23, 2017
Key facts
- NPI
- 1316464183
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ALABAMA PROVIDENCE HEALTHCARE SERVICES
- Practice address
- 411 N Section St
Fairhope, AL 36532-2649 - Phone
- (251) 342-3949
- NPI assigned
- Aug 23, 2017
- Organization subpart
- No
Authorized official
- Name
- Todd Kennedy
- Title
- President
- Phone
- (251) 633-1000
Corporate family (same tax ID) 26
National Provider Directory
- Tax ID family
- Alabama Providence Healthcare Services
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
411 N Section St
Fairhope, AL 36532-2649
Mailing address
PO Box 850489
Mobile, AL 36685-0489
Phone (251) 342-3949
Other names
- Providence Medical Group - Fairhope
Other providers in Fairhope, AL
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- Alabama Dental Professionals PC
- Alan B Melton DMD PC
- Carl E. Albertson
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All providers in Fairhope, AL · Family Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.