Healthcare Provider Details

I. General information

NPI: 1447164801
Provider Name (Legal Business Name): GARRETT KINSEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5721 USA DRIVE NORTH HAHN 3042
MOBILE AL
36688-0001
US

IV. Provider business mailing address

1200 SOMERBY DR APT 1225
MOBILE AL
36695-5438
US

V. Phone/Fax

Practice location:
  • Phone: 251-445-9250
  • Fax:
Mailing address:
  • Phone: 251-591-4905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: