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General NPI Number Information
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NPI Number | 1558382671
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Entity Type | Organization
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Legal Business Name | MOBILE SURGICAL SERVICES, P.C.
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 12/17/2008
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Provider Practice Location Address
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Address Line | 6701 AIRPORT BLVD SUITE D231
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City | MOBILE
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State | AL
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Zip | 36608-6705
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Country | US
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Telephone | 251-633-4064
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Fax | 251-633-0122
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Provider Business Mailing Address
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Address Line | 6701 AIRPORT BLVD SUITE D231
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City | MOBILE
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State | AL
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Zip | 36608-6705
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Country | US
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Telephone | 251-633-4064
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Fax | 251-633-0122
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM MALCOLM LIGHTFOOT
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Credential | M.D.
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Telephone | 251-633-4064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 00026047
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 00006907
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License Number State | AL
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