Provider Demographics
NPI:1689778318
Name:SURGEONS OF MOBILE PC
Entity Type:Organization
Organization Name:SURGEONS OF MOBILE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:ELDON
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:251-344-1800
Mailing Address - Street 1:101 MEMORIAL HOSPITAL DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1787
Mailing Address - Country:US
Mailing Address - Phone:251-344-1800
Mailing Address - Fax:251-341-1075
Practice Address - Street 1:101 MEMORIAL HOSPITAL DR
Practice Address - Street 2:SUITE 301
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1787
Practice Address - Country:US
Practice Address - Phone:251-344-1800
Practice Address - Fax:251-341-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D236Medicare ID - Type Unspecified