Provider Demographics
NPI:1730580556
Name:SPRINGHILL PHYSICIAN PRACTICES, INC
Entity type:Organization
Organization Name:SPRINGHILL PHYSICIAN PRACTICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BECKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-460-5280
Mailing Address - Street 1:3715 DAUPHIN ST
Mailing Address - Street 2:7A
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1771
Mailing Address - Country:US
Mailing Address - Phone:251-410-4001
Mailing Address - Fax:251-410-4002
Practice Address - Street 1:3715 DAUPHIN ST
Practice Address - Street 2:505A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1771
Practice Address - Country:US
Practice Address - Phone:251-410-4001
Practice Address - Fax:251-410-4002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRINGHILL PHYSICIAN PRACTICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-11
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL890066261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510G700022Medicare PIN