Basic Information
| Provider Information | |||||||||
| NPI: | 1629411731 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADHD MEDICAL CLINIC OF MOBILE, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7627 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366700627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514457266 | ||||||||
| FaxNumber: | 2514106079 | ||||||||
| Practice Location | |||||||||
| Address1: | 2404 SPRING HILL AVE | ||||||||
| Address2: | UNIT 114 | ||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366073029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514457266 | ||||||||
| FaxNumber: | 2514106079 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2013 | ||||||||
| LastUpdateDate: | 04/09/2013 | ||||||||
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| AuthorizedOfficialLastName: | INGE | ||||||||
| AuthorizedOfficialFirstName: | FRANCES | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2514457266 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 22050 | AL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.