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ALABAMA PROVIDENCE HEALTHCARE SERVICES NPI 1700215894


NPI Information

NPI: 1700215894
Provider Name: ALABAMA PROVIDENCE HEALTHCARE SERVICES

Other Name: PROVIDENCE MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 01D1003400

Address:
19140 S 3RD ST
CITRONELLE, AL
ZIP 36522
Phone: (251) 866-0086
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ALABAMA PROVIDENCE HEALTHCARE SERVICES is a family medicine in Citronelle, AL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ALABAMA PROVIDENCE HEALTHCARE SERVICES NPI is 1700215894. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Providence Medical Group.

The provider's business location address is:

19140 S 3RD ST
CITRONELLE, AL
ZIP 36522-306
Phone: (251) 866-0086
Fax: (251) 866-0089

The provider's authorized official is Todd S. Kennedy .
The authorized official title is President and has the following contact phone number (251) 633-1660.

The CLIA number assigned to this NPI record is 01D1003400 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/8/2013 and was last updated on 9/28/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineNo
2207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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