| Providence Medical Group | |
|
18 Rambo Dr Saraland AL 36571-2147 | |
| (251) 675-7433 | |
| (251) 675-3470 |
| Full Name | Providence Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 18 Rambo Dr, Saraland, Alabama |
| Authorized Official Name and Position | Todd S. Kennedy (PRESIDENT) |
| Authorized Official Contact | 2516331660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Po Box 850489 Mobile AL 36685-0489 Ph: (251) 342-3949 | Providence Medical Group 18 Rambo Dr Saraland AL 36571-2147 Ph: (251) 675-7433 |
| NPI Number | 1083043822 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 09/28/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083043822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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