Healthcare Provider Details

I. General information

NPI: 1811051675
Provider Name (Legal Business Name): PET CT OF MOBILE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEMORIAL HOSPITAL DR SUITE 1E
MOBILE AL
36608
US

IV. Provider business mailing address

PO BOX 7687
MOBILE AL
36670-0687
US

V. Phone/Fax

Practice location:
  • Phone: 251-316-3868
  • Fax: 251-316-3583
Mailing address:
  • Phone: 251-316-3868
  • Fax: 261-316-3583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH ROWEN ZURFLUH
Title or Position: MANAGER
Credential:
Phone: 251-633-0573