Healthcare Provider Details

I. General information

NPI: 1376316869
Provider Name (Legal Business Name): MOBILE-OMS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 DOWNTOWNER BLVD
MOBILE AL
36609-5401
US

IV. Provider business mailing address

715 DOWNTOWNER BLVD
MOBILE AL
36609-5401
US

V. Phone/Fax

Practice location:
  • Phone: 251-741-3381
  • Fax: 251-471-3383
Mailing address:
  • Phone: 251-741-3381
  • Fax: 251-471-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER MULLENIX
Title or Position: OWNER/ORAL SURGEON
Credential: DMD, MD
Phone: 251-471-3381