Healthcare Provider Details

I. General information

NPI: 1689141665
Provider Name (Legal Business Name): USA HCA OBGYN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 10/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 STANTON RD
MOBILE AL
36617-2343
US

IV. Provider business mailing address

6701 AIRPORT BLVD STE A101
MOBILE AL
36608-6767
US

V. Phone/Fax

Practice location:
  • Phone: 251-479-0058
  • Fax: 251-479-1585
Mailing address:
  • Phone: 251-378-6209
  • Fax: 251-378-6222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ERICA MADISON
Title or Position: CREDENTIALING
Credential:
Phone: 251-378-6209