Healthcare Provider Details

I. General information

NPI: 1881805406
Provider Name (Legal Business Name): SHERRI SULLIVAN ARLEDGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3719 DAUPHIN ST
MOBILE AL
36608-1753
US

IV. Provider business mailing address

29653 ANCHOR CROSS BLVD
DAPHNE AL
36526-9594
US

V. Phone/Fax

Practice location:
  • Phone: 251-625-6896
  • Fax: 251-625-6897
Mailing address:
  • Phone: 251-625-6896
  • Fax: 251-625-6897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number28132
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number17987
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number28132
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: