Providence Medical Group
LBN: Providence Healthcare Services
Providence Medical Group is an health care organization with primary practice located at 6701 Airport Blvd Suite A101, Mobile AL 36608-6705. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, Allopathic & Osteopathic Physicians / Gastroenterology, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Providence Healthcare Services can be contacted via phone (251) 633-8880, or through Christianson, Clark P. via phone (251) 633-1660.
Contact Information
Primary practice address
6701 Airport Blvd Suite A101
Mobile AL 36608-6705
Phone: (251) 633-8880
Fax: (251) 633-2817
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | ||
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | ||
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X |
Profile Details
| NPI number | 1386848356 |
|---|---|
| LBN Legal business name | Providence Healthcare Services |
| DBA Doing business as | Providence Medical Group |
| Authorized official | Christianson, Clark P. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 13th, 2007 |
| Last updated | Sep 13th, 2012 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386848356 | NPPES |
| Alabama | MEDICAID | 529907120 |
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