Provider Demographics
NPI:1568407856
Name:MOBLEY, NORMA DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMA
Middle Name:DENISE
Last Name:MOBLEY
Suffix:
Gender:F
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 91899
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36691-1899
Mailing Address - Country:US
Mailing Address - Phone:251-342-8900
Mailing Address - Fax:
Practice Address - Street 1:6321 PICCADILLY SQUARE DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5306
Practice Address - Country:US
Practice Address - Phone:251-342-8900
Practice Address - Fax:251-342-2333
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00023492208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009975025Medicaid
AL51524999OtherBLUE CROSS/BLUE SHIELD