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General NPI Number Information
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NPI Number | 1063913630
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Entity Type | Organization
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Legal Business Name | NEW SOUTH PSYCHIATRY,PC
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 3209 MIDTOWN PARK S
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City | MOBILE
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State | AL
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Zip | 36606-4126
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Country | US
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Telephone | 251-525-9090
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Fax | 251-525-9091
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Provider Business Mailing Address
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Address Line | 3209 MIDTOWN PARK S
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City | MOBILE
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State | AL
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Zip | 36606-4126
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Country | US
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Telephone | 251-525-9090
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Fax | 251-525-9091
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK A HAYGOOD
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Credential | DO
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Telephone | 251-380-6241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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