Healthcare Provider Details

I. General information

NPI: 1427349919
Provider Name (Legal Business Name): MOBILITY METABOLISM & WELLNESS P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4357 MIDMOST DR
MOBILE AL
36609-5505
US

IV. Provider business mailing address

4357 MIDMOST DR
MOBILE AL
36609-5505
US

V. Phone/Fax

Practice location:
  • Phone: 251-345-0773
  • Fax: 877-806-8642
Mailing address:
  • Phone: 251-345-0773
  • Fax: 877-806-8642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number24535
License Number StateAL

VIII. Authorized Official

Name: DR. JAMES M CRUMB
Title or Position: PRESIDENT
Credential: M. D.
Phone: 251-345-0773