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General NPI Number Information
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NPI Number | 1750346144
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Entity Type | Organization
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Legal Business Name | MOBILE PATHOLOGY GROUP, PA
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 6701 AIRPORT BLVD SUITE B 218
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City | MOBILE
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State | AL
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Zip | 36608-6776
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Country | US
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Telephone | 251-633-3617
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Fax | 251-633-9330
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Provider Business Mailing Address
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Address Line | 5700 SOUTHWYCK BLVD
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City | TOLEDO
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State | OH
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Zip | 43614-1509
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Country | US
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Telephone | 800-288-8325
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Fax | 419-866-5453
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Authorized Official
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Title or Position | HEAD PHYSICIAN
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Name | TODD J KENDALL
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Credential | MD
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Telephone | 251-633-3617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 7939
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 13909
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 00022814
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License Number State | AL
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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