Basic Information
| Provider Information | |||||||||
| NPI: | 1073722708 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MOBILE FAMILY PHYSICIANS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1924-K DAUPHIN ISLAND PARKWAY | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514766330 | ||||||||
| FaxNumber: | 2514731083 | ||||||||
| Practice Location | |||||||||
| Address1: | 1924-K DAUPHIN ISLAND PARKWAY | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514766330 | ||||||||
| FaxNumber: | 2514731083 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | NEAL | ||||||||
| AuthorizedOfficialFirstName: | ELEANOR | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2514766330 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 92780 | 01 | BCBS RONALD W PERDUE | OTHER | 3489 | 01 | BCBS ROBERT L KOMINEK | OTHER | 1598772204 | 01 | NPI MARK C WILES | OTHER | 1649286188 | 01 | NPI LEON D MCLAUGHLIN | OTHER | 1669489340 | 01 | NPI TEXEL D JOHNSON | OTHER | 13975 | 01 | BCBS TEXEL D JOHNSON | OTHER | 1558377002 | 01 | NPI HENRIETTA T KOVACS | OTHER | 1730196437 | 01 | NPI RONALD W PERDUE | OTHER | 4235 | 01 | BCBS LEON D MCLAUGHLIN | OTHER | 1811915242 | 01 | NPI ROBERT L KOMINEK | OTHER | 19606 | 01 | BCBS MARK C WILES | OTHER | 29364 | 01 | BCBS HENRIETTA T KOVACS | OTHER |