Provider Demographics
NPI:1700140779
Name:COASTAL INPATIENT PHYSICIANS PC
Entity Type:Organization
Organization Name:COASTAL INPATIENT PHYSICIANS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-988-1117
Mailing Address - Street 1:10 N SECTION ST # 99
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-2205
Mailing Address - Country:US
Mailing Address - Phone:251-988-1117
Mailing Address - Fax:
Practice Address - Street 1:750 MORPHY AVE
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1812
Practice Address - Country:US
Practice Address - Phone:251-988-1117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty