Provider Demographics
NPI:1821246414
Name:INFIRMARY WEST SURGICAL SPECIALISTS
Entity Type:Organization
Organization Name:INFIRMARY WEST SURGICAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ORMAND
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-660-5210
Mailing Address - Street 1:3401 MEDICAL PARK DR
Mailing Address - Street 2:3 MEDICAL PARK SUITE 105
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3318
Mailing Address - Country:US
Mailing Address - Phone:251-660-5589
Mailing Address - Fax:251-660-5598
Practice Address - Street 1:3401 MEDICAL PARK DR
Practice Address - Street 2:3 MEDICAL PARK SUITE 105
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3318
Practice Address - Country:US
Practice Address - Phone:251-660-5589
Practice Address - Fax:251-660-5598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INFIRMARY HEALTH HOSPITALS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty