Healthcare Provider Details

I. General information

NPI: 1023863388
Provider Name (Legal Business Name): MIDTOWN HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2024
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 BEL AIR BLVD STE 9
MOBILE AL
36606-3502
US

IV. Provider business mailing address

602 BEL AIR BLVD STE 9
MOBILE AL
36606-3502
US

V. Phone/Fax

Practice location:
  • Phone: 251-533-3143
  • Fax: 251-650-1525
Mailing address:
  • Phone: 251-533-3143
  • Fax: 251-650-1525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ILENE BOYKIN
Title or Position: OWNER
Credential: FNP-NP-C
Phone: 251-533-3143