Healthcare Provider Details

I. General information

NPI: 1558534933
Provider Name (Legal Business Name): NEPHROLOGY ASSOCIATES OF MOBILE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 S UNIVERSITY BLVD STE A
MOBILE AL
36608-3078
US

IV. Provider business mailing address

PO BOX 850849
MOBILE AL
36685-0849
US

V. Phone/Fax

Practice location:
  • Phone: 251-343-5004
  • Fax: 251-343-5136
Mailing address:
  • Phone: 251-343-5004
  • Fax: 251-343-5136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-080490
License Number StateAL

VIII. Authorized Official

Name: DAVID SWEET
Title or Position: CEO
Credential:
Phone: 251-300-6969