Healthcare Provider Details

I. General information

NPI: 1063477644
Provider Name (Legal Business Name): MOBILE HEART SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD SUITE A-107
MOBILE AL
36608-6705
US

IV. Provider business mailing address

6701 AIRPORT BLVD SUITE A-107
MOBILE AL
36608-6705
US

V. Phone/Fax

Practice location:
  • Phone: 251-433-4700
  • Fax: 251-435-8615
Mailing address:
  • Phone: 251-433-4700
  • Fax: 251-435-8615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MR. BELINDA L ROGERS
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 251-435-8572