Healthcare Provider Details

I. General information

NPI: 1457448219
Provider Name (Legal Business Name): RICHARD F HWANG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402B OLD SHELL RD
MOBILE AL
36608-1912
US

IV. Provider business mailing address

4402B OLD SHELL RD
MOBILE AL
36608-1912
US

V. Phone/Fax

Practice location:
  • Phone: 251-633-0123
  • Fax: 251-445-3722
Mailing address:
  • Phone: 251-633-0123
  • Fax: 251-445-3722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number00026047
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26047
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: