Providence Healthcare Services

Organization Gynecologic Oncology Physician · NPI 1164683595

Providence Healthcare Services provides Gynecologic Oncology Physician services in Daphne, Alabama. Registered with an NPI since 2008.

In the registry since: 2008

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Practice location Address checks out

29653 Anchor Cross Blvd
Daphne, AL 36526-9594 Not confirmed with CMS for 14 years — call before visiting
Phone: (251) 631-3490
Fax: (251) 631-3461

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gynecologic Oncology Physician (primary)	Taxonomy 207VX0201X

Record details

NPI number	1164683595
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Clark Christianson — President · (251) 631-3574
Other names	Providence Medical Group
NPI enumerated	June 18, 2008
Last updated in NPPES	August 27, 2012
Mailing address	Po Box 850489, Mobile, AL 36685-0489