Provider Demographics
NPI:1073722708
Name:MOBILE FAMILY PHYSICIANS PC
Entity Type:Organization
Organization Name:MOBILE FAMILY PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:N
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-476-6330
Mailing Address - Street 1:1924-K DAUPHIN ISLAND PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36605
Mailing Address - Country:US
Mailing Address - Phone:251-476-6330
Mailing Address - Fax:251-473-1083
Practice Address - Street 1:1924-K DAUPHIN ISLAND PARKWAY
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36605
Practice Address - Country:US
Practice Address - Phone:251-476-6330
Practice Address - Fax:251-473-1083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
92780OtherBCBS RONALD W PERDUE
3489OtherBCBS ROBERT L KOMINEK
1598772204OtherNPI MARK C WILES
1649286188OtherNPI LEON D MCLAUGHLIN
1669489340OtherNPI TEXEL D JOHNSON
13975OtherBCBS TEXEL D JOHNSON
1558377002OtherNPI HENRIETTA T KOVACS
1730196437OtherNPI RONALD W PERDUE
4235OtherBCBS LEON D MCLAUGHLIN
1811915242OtherNPI ROBERT L KOMINEK
19606OtherBCBS MARK C WILES
29364OtherBCBS HENRIETTA T KOVACS
C72436Medicare UPIN
1649286188OtherNPI LEON D MCLAUGHLIN
1669489340OtherNPI TEXEL D JOHNSON
1558377002OtherNPI HENRIETTA T KOVACS
29364OtherBCBS HENRIETTA T KOVACS
19606OtherBCBS MARK C WILES