Provider Demographics
NPI:1952197972
Name:CROTWELL ORTHOPEDIC CLINIC
Entity type:Organization
Organization Name:CROTWELL ORTHOPEDIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-222-9319
Mailing Address - Street 1:720 HILLCREST RD STE B
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-3904
Mailing Address - Country:US
Mailing Address - Phone:512-724-9342
Mailing Address - Fax:251-460-5457
Practice Address - Street 1:720 HILLCREST RD STE B
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36695-3904
Practice Address - Country:US
Practice Address - Phone:251-272-4934
Practice Address - Fax:251-460-5457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty