| University Of South Alabama Health Services Foundation | |
|
2451 Fillingim St Mastin Bldg. 617 Mobile AL 36617-2238 | |
| (251) 470-5842 | |
| (251) 470-5809 |
| Full Name | University Of South Alabama Health Services Foundation |
|---|---|
| Speciality | Clinic/Center |
| Location | 2451 Fillingim St, Mobile, Alabama |
| Authorized Official Name and Position | Becky S. Tate (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2514705842 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of South Alabama Health Services Foundation Po Box 40480 Mobile AL 36640-0480 Ph: (251) 470-5842 | University Of South Alabama Health Services Foundation 2451 Fillingim St Mastin Bldg. 617 Mobile AL 36617-2238 Ph: (251) 470-5842 |
| NPI Number | 1962455881 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 8426957952 |
|---|---|
| Medicare Enrollment ID | O20040105000373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962455881 | NPI | - | NPPES |
| GSD600 | Medicaid | AL | |
| 1445061 | Medicaid | LA | |
| F882 | Other | AL | BCBS COMMON PAY # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Alabama) | Primary |
| Provider Name | John Alan Vande Waa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447290630 PECOS PAC ID: 8527971191 Enrollment ID: I20040312000145 |
| Provider Name | Hercules Panayiotou |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609822162 PECOS PAC ID: 1456346212 Enrollment ID: I20040420000266 |
| Provider Name | Stephen T Varner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306883624 PECOS PAC ID: 1052300662 Enrollment ID: I20040510000455 |
| Provider Name | James V Courtney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184627796 PECOS PAC ID: 1658359641 Enrollment ID: I20040707001202 |
| Provider Name | Brian W Fouty |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740234327 PECOS PAC ID: 6406828524 Enrollment ID: I20040825000605 |
| Provider Name | Shannon K Tyler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205883154 PECOS PAC ID: 6103892575 Enrollment ID: I20040907001223 |
| Provider Name | Roy M Culpepper |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1760433767 PECOS PAC ID: 6709837818 Enrollment ID: I20050207000431 |
| Provider Name | Anthony M Martino |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1841238011 PECOS PAC ID: 4385548106 Enrollment ID: I20050329000653 |
| Provider Name | Tangela C Atkinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659320786 PECOS PAC ID: 7214977701 Enrollment ID: I20050504000359 |
| Provider Name | Reynaldo L Rodriguez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023055340 PECOS PAC ID: 3375583099 Enrollment ID: I20050511000842 |
| Provider Name | Druhan L Howell |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1790877892 PECOS PAC ID: 9931136355 Enrollment ID: I20050718000741 |
| Provider Name | Errol D Crook |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1235181181 PECOS PAC ID: 7214965755 Enrollment ID: I20050727000302 |
| Provider Name | George A Eyrich |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962493171 PECOS PAC ID: 3173553252 Enrollment ID: I20050818000183 |
| Provider Name | Samuel A Mcquiston |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649223462 PECOS PAC ID: 4981636479 Enrollment ID: I20050906000692 |
| Provider Name | Bassam A Omar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073568895 PECOS PAC ID: 2365477569 Enrollment ID: I20050927000653 |
| Provider Name | John C Schultz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215975545 PECOS PAC ID: 9638198245 Enrollment ID: I20051114000245 |
| Provider Name | Carmen G May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043264294 PECOS PAC ID: 5799704201 Enrollment ID: I20051114001166 |
| Provider Name | Carol P Motley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003866112 PECOS PAC ID: 0345256731 Enrollment ID: I20060222000277 |
| Provider Name | Robert A Perkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184663296 PECOS PAC ID: 8325054372 Enrollment ID: I20060228000382 |
| Provider Name | Frederick M Silver |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1053350710 PECOS PAC ID: 8022026285 Enrollment ID: I20060329000547 |
| Provider Name | Roy E Gandy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225036312 PECOS PAC ID: 9234141151 Enrollment ID: I20060614000323 |
| Provider Name | Mark B Leflore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154375376 PECOS PAC ID: 1951313675 Enrollment ID: I20060621000263 |
| Provider Name | Joan N Friedlander |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417996778 PECOS PAC ID: 4587676135 Enrollment ID: I20060622000197 |
| Provider Name | Shikha Gupta |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1235189085 PECOS PAC ID: 6406868793 Enrollment ID: I20060705000267 |
| Provider Name | Brad A Steffler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265486708 PECOS PAC ID: 1153324934 Enrollment ID: I20060816000549 |
| Provider Name | John C Lafleur |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316989486 PECOS PAC ID: 5597769968 Enrollment ID: I20060828000324 |
| Provider Name | Sheri J Kovaleski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225082407 PECOS PAC ID: 8921002981 Enrollment ID: I20060905000445 |
| Provider Name | Andrea G Kahn |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1568576254 PECOS PAC ID: 1951307552 Enrollment ID: I20061004000324 |
| Provider Name | Eduardo G Calderon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952379109 PECOS PAC ID: 1052212198 Enrollment ID: I20061128000377 |
| Provider Name | Mary Jane Hancock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417028903 PECOS PAC ID: 1658372057 Enrollment ID: I20070129000169 |
| Provider Name | James Carter |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1215988696 PECOS PAC ID: 9234239666 Enrollment ID: I20070713000285 |
| Provider Name | Jacek M Polski |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1760437727 PECOS PAC ID: 0547361909 Enrollment ID: I20070730000214 |
| Provider Name | Terry J Hundley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992855886 PECOS PAC ID: 1153413802 Enrollment ID: I20070825000049 |
| Provider Name | Mark Perry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437114402 PECOS PAC ID: 8325131873 Enrollment ID: I20070829000833 |
| Provider Name | Ruth L Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558309732 PECOS PAC ID: 7517041239 Enrollment ID: I20080219000820 |
| Provider Name | Karen Fagan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053401737 PECOS PAC ID: 2163493941 Enrollment ID: I20080512000431 |
| Provider Name | Olivette T Hundley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427199470 PECOS PAC ID: 4981771045 Enrollment ID: I20080916000399 |
| Provider Name | Dean K Naritoku |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386625507 PECOS PAC ID: 9335201094 Enrollment ID: I20081215000645 |
| Provider Name | Jessica L Kirk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699817536 PECOS PAC ID: 0547322315 Enrollment ID: I20090105000186 |
| Provider Name | Karen D Crissinger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225089220 PECOS PAC ID: 9133272016 Enrollment ID: I20090727000137 |
| Provider Name | Cristina E Gavrilita |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1245492453 PECOS PAC ID: 2567516206 Enrollment ID: I20090814000624 |
| Provider Name | William O Richards |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548368491 PECOS PAC ID: 7810922184 Enrollment ID: I20090922000429 |
| Provider Name | Paul F Rider |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1538329446 PECOS PAC ID: 1557407681 Enrollment ID: I20091005000060 |
| Provider Name | Stephanie J Anderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053501049 PECOS PAC ID: 9638215395 Enrollment ID: I20091009000320 |
| Provider Name | Anne Marie D Kaulfers |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639386733 PECOS PAC ID: 8224175484 Enrollment ID: I20091021000491 |
| Provider Name | Elizabeth Manci |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073567293 PECOS PAC ID: 2668507872 Enrollment ID: I20100312000729 |
| Provider Name | Barbara A Burckhartt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861442014 PECOS PAC ID: 5496881229 Enrollment ID: I20100331000118 |
| Provider Name | Susan Baker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538118997 PECOS PAC ID: 6002943628 Enrollment ID: I20100429000772 |
| Provider Name | Juvonda Hodge |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831144260 PECOS PAC ID: 5991834608 Enrollment ID: I20100518000603 |
| Provider Name | Richard Whitehurst |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336189745 PECOS PAC ID: 2062541683 Enrollment ID: I20100520000088 |
| Provider Name | William Broughton |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1609827104 PECOS PAC ID: 5092844639 Enrollment ID: I20100520000324 |
| Provider Name | Ladonna Crews |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003866005 PECOS PAC ID: 8527197185 Enrollment ID: I20100520000581 |
| Provider Name | Michael Cohen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710938162 PECOS PAC ID: 3173653714 Enrollment ID: I20100609000184 |
| Provider Name | Jorge Herrera |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316986193 PECOS PAC ID: 7810027372 Enrollment ID: I20100609000565 |
| Provider Name | Desiree A Soter-pearsall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649225921 PECOS PAC ID: 1759444029 Enrollment ID: I20100614000790 |
| Provider Name | Rosa Vidal |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1578503751 PECOS PAC ID: 2163552175 Enrollment ID: I20100617000061 |
| Provider Name | Sidney B Brevard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487675740 PECOS PAC ID: 4587766407 Enrollment ID: I20100928001314 |
| Provider Name | Juan G Ochoa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013986041 PECOS PAC ID: 2769576578 Enrollment ID: I20101004000972 |
| Provider Name | Abdul H Siddiqui |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225203078 PECOS PAC ID: 4385831007 Enrollment ID: I20101207001196 |
| Provider Name | Kari Bradham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194987503 PECOS PAC ID: 0941488282 Enrollment ID: I20110711000110 |
| Provider Name | David Albert Gremse |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750369468 PECOS PAC ID: 7315838646 Enrollment ID: I20120607000035 |
Sunbelt Patient Solutions Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5901 Airport Blvd Ste 203, Mobile, AL 36608 Phone: 504-648-7924 | |
Usa Department Of Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1504 Springhill Avenue, Suite 1600, Mobile, AL 36604 Phone: 251-434-3915 Fax: 251-434-3802 | |
Mobile County Board Of Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 251 N Bayou St, Mobile, AL 36603 Phone: 251-690-8158 Fax: 251-690-8852 | |
Dr Albert Thomas Family Medical Ctr Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1904 Bishop Ave, Mobile, AL 36610 Phone: 251-452-1010 Fax: 251-436-7765 | |
Usa Mitchell Cancer Institute Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1660 Springhill Ave, Mobile, AL 36604 Phone: 251-665-8000 Fax: 251-665-8010 | |
Springhill Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1201 Springhill Ave, Mobile, AL 36604 Phone: 251-694-1801 Fax: 251-694-1890 | |
Bay Area Community Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3737 Government Blvd, Suite408, Mobile, AL 36693 Phone: 251-602-1911 |