Provider Demographics
NPI:1467430777
Name:PURSLEY, MICHAEL S (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:S
Last Name:PURSLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 850266
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0266
Mailing Address - Country:US
Mailing Address - Phone:251-990-1920
Mailing Address - Fax:251-990-1921
Practice Address - Street 1:150 S INGLESIDE ST
Practice Address - Street 2:4 MEDICAL PARK
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1803
Practice Address - Country:US
Practice Address - Phone:251-990-1920
Practice Address - Fax:251-990-1921
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25610174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009936433Medicaid
AL051554382Medicaid
AL1609095157OtherMEDICARE GROUP NPI
MS05538519Medicaid
AL1467430777OtherINDIVIDUAL NPI
ALK814OtherMEDICARE GROUP
AL009936436Medicaid
AL009936467Medicaid
AL009936434Medicaid
ALP00292990Medicare PIN
AL1467430777OtherINDIVIDUAL NPI
H55147Medicare UPIN
AL051554382Medicare PIN
ALK814OtherMEDICARE GROUP
AL051557407Medicare PIN