Healthcare Provider Details

I. General information

NPI: 1891439014
Provider Name (Legal Business Name): ANTHONY THOMAS NOLL DO, MHA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2022
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR
MOBILE AL
36617-2300
US

IV. Provider business mailing address

2451 UNIVERSITY HOSPITAL DR
MOBILE AL
36617-2300
US

V. Phone/Fax

Practice location:
  • Phone: 251-434-3475
  • Fax: 251-434-3837
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number4583
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: