Healthcare Provider Details

I. General information

NPI: 1336057603
Provider Name (Legal Business Name): TELOMERE CONCIERGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2864 DAUPHIN ST STE A
MOBILE AL
36606-2440
US

IV. Provider business mailing address

2864 DAUPHIN ST STE A
MOBILE AL
36606-2440
US

V. Phone/Fax

Practice location:
  • Phone: 251-220-7051
  • Fax: 888-568-9230
Mailing address:
  • Phone: 251-220-7051
  • Fax: 888-568-9230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL SMITH
Title or Position: CEO
Credential: PA-C
Phone: 251-709-9110