Healthcare Provider Details

I. General information

NPI: 1568073179
Provider Name (Legal Business Name): ALICIA TEI LINDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2020
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 SCHILLINGER RD S STE A
MOBILE AL
36695-4177
US

IV. Provider business mailing address

2350 SCHILLINGER RD S STE A
MOBILE AL
36695-4177
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 TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1864
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: