Healthcare Provider Details

I. General information

NPI: 1689623076
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES OF MOBILE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD STE D330
MOBILE AL
36608-6758
US

IV. Provider business mailing address

6701 AIRPORT BLVD SUITE D-330
MOBILE AL
36608-6705
US

V. Phone/Fax

Practice location:
  • Phone: 251-607-9797
  • Fax: 251-607-9761
Mailing address:
  • Phone: 251-607-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GERRY M PHILLIPS
Title or Position: PRESIDENT
Credential: MD
Phone: 251-607-9797