Providence Healthcare Services

NPI #1053515353 in Semmes, Alabama

Provider Information

NPI Number: 1053515353
Entity Type: Organization
Organization Name: Providence Healthcare Services
Primary Specialty: Family Medicine
Enumeration Date: Jun 12, 2007
Last Updated: Aug 27, 2012

Practice Location

Address: 8010 MOFFETT RD
City: Semmes
State: Alabama
ZIP Code: 36575-5406
Phone: (251) 645-8946

Authorized Official

Name: MR. CLARK P. CHRISTIANSON
Title: PRESIDENT
Phone: (251) 631-3574

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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