Healthcare Provider Details

I. General information

NPI: 1790657617
Provider Name (Legal Business Name): AIDAN HALE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

51 TACON ST STE D
MOBILE AL
36607-3123
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-2400
  • Fax:
Mailing address:
  • Phone: 251-341-2879
  • Fax: 251-316-3050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: