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PROVIDENCE MEDICAL GROUP
NPI 1164683595
Obstetrics & Gynecology - Gynecologic Oncology in Daphne, AL

Active since June 18, 2008
29653 ANCHOR CROSS BLVD, DAPHNE, AL 36526(251) 631-3490(251) 631-3461 Get Directions Write a Review

NPPES record last updated: August 27, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE MEDICAL GROUP (NPI 1164683595) is a healthcare organization registered as a gynecologic oncology in Daphne, Alabama and active in the NPI registry since June 2008. The organization lists Clark P. Christianson, President, as its authorized official.

NPPES Registry Identity

NPI1164683595
Entity TypeOrganization
Primary Taxonomy207VX0201X
Legal Business NamePROVIDENCE HEALTHCARE SERVICES
Location Address29653 ANCHOR CROSS BLVDDaphne, AL 36526-9594
Mailing AddressPo Box 850489Mobile, AL 36685-0489 · (251) 342-3949 · Fax (251) 631-3361
Phone(251) 631-3490
Fax(251) 631-3461
Organization SubpartNo
Authorized OfficialClark P. ChristiansonPresident · (251) 631-3574
Enumeration DateJune 18, 2008
Last NPPES UpdateAugust 27, 2012
✔ NPI 1164683595 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Gynecologic OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207VX0201X
Definition
An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications.
29653 ANCHOR CROSS BLVD, Daphne, AL 36526
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Other Names 1

Doing Business AsProvidence Medical Group

Other Identifiers 2

Medicare PINH970AL
Medicaid529907120AL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRITTANY HOLLEY CASE M.D.
Internal Medicine (Medical Oncology)
29653 ANCHOR CROSS BLVD
DAPHNE, AL 36526
Baldwin County (251) 625-6896
DR. JOSEPH REECE JONES M.D.
Internal Medicine (Hematology & Oncology)
29653 ANCHOR CROSS BLVD
DAPHNE, AL 36526
Baldwin County (251) 625-6896
ANCHOR CROSS MEDICAL SOLUTIONS
Contractor
29653 ANCHOR CROSS BLVD
DAPHNE, AL 36526
Baldwin County (251) 625-6896
BETHANY KING CRNP
Nurse Practitioner (Family)
29653 ANCHOR CROSS BLVD
DAPHNE, AL 36526
Baldwin County (251) 625-6896
GULF COAST DERMATOLOGY AND SKIN CARE CENTRE PLLC
Dermatology
29653 ANCHOR CROSS BLVD
DAPHNE, AL 36526
Baldwin County (251) 631-3570
SOUTHERN CANCER CENTER, PC
Pharmacy
29653 ANCHOR CROSS BLVD, SUTIE A 101
DAPHNE, AL 36526
Baldwin County (251) 607-5061
VANTAGE CANCER CARE NETWORK OF ALABAMA, LLC
Internal Medicine (Medical Oncology)
29653 ANCHOR CROSS BLVD
DAPHNE, AL 36526
Baldwin County (251) 626-1755
VANTAGE CANCER CARE - ALABAMA, LLC
Internal Medicine (Medical Oncology)
29653 ANCHOR CROSS BLVD
DAPHNE, AL 36526
Baldwin County (251) 626-1755

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Healthcare Services's NPI number?

The NPI number for Providence Healthcare Services is 1164683595. It was assigned to this organization in the NPPES registry on June 18, 2008. The provider is doing business as Providence Medical Group.

Where is Providence Healthcare Services located?

Providence Healthcare Services is located at 29653 Anchor Cross Blvd, Daphne, AL 36526. The listed phone number is (251) 631-3490.

What is Providence Healthcare Services's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecologic Oncology, with taxonomy code 207VX0201X.

When was this NPI record last updated?

The NPPES record for Providence Healthcare Services was last updated on August 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.