Providence Healthcare Services

NPI #1255535662 in Mobile, Alabama

Provider Information

NPI Number: 1255535662
Entity Type: Organization
Organization Name: Providence Healthcare Services
Primary Specialty: Internal Medicine
Enumeration Date: Jun 12, 2007
Last Updated: Aug 27, 2012

Practice Location

Address: 610 PROVIDENCE PARK DR E
Address 2: BLDG. 1 SUITE 102
City: Mobile
State: Alabama
ZIP Code: 36695-4622
Phone: (251) 378-3900

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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