Healthcare Provider Details

I. General information

NPI: 1619920741
Provider Name (Legal Business Name): NURSING HOME PHYSICIAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 DAUPHIN ST
MOBILE AL
36604-2532
US

IV. Provider business mailing address

ONE SOUTHERN WAY SUITE A
MOBILE AL
36619-1210
US

V. Phone/Fax

Practice location:
  • Phone: 251-433-9801
  • Fax: 251-433-9807
Mailing address:
  • Phone: 251-433-9801
  • Fax: 251-432-3630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MATTHEW J HALL
Title or Position: CFO
Credential:
Phone: 251-433-9801