| Providence Medical Group - Fairhope | |
|
411 N Section St Fairhope AL 36532-2649 | |
| (251) 342-3949 | |
| Not Available |
| Full Name | Providence Medical Group - Fairhope |
|---|---|
| Speciality | Family Medicine |
| Location | 411 N Section St, Fairhope, Alabama |
| Authorized Official Name and Position | Todd Kennedy (PRESIDENT) |
| Authorized Official Contact | 2516331000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group - Fairhope Po Box 850489 Mobile AL 36685-0489 Ph: (251) 342-3949 | Providence Medical Group - Fairhope 411 N Section St Fairhope AL 36532-2649 Ph: (251) 342-3949 |
| NPI Number | 1316464183 |
|---|---|
| Provider Enumeration Date | 08/23/2017 |
| Last Update Date | 08/23/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316464183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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