IMC-CANCER SURGERY OF MOBILE, LLC (NPI# 1063714012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063714012 |
| Entity Type | Organization |
| Organization Name | IMC-CANCER SURGERY OF MOBILE, LLC |
| Practice Address |
3 Mobile Infirmary Cir Suite 305 Mobile AL 36607-3520 |
| Practice Telephone | 2514335557 |
| Practice Fax Number | 2514335558 |
| Mailing Telephone | 2514335557 |
| Mailing Fax Number | 2514335558 |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2019-11-01 |
| Authorized Official Name | MR. ANTHONY PALAZZO (VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 2514351361 |
| Is Organization Subpart | Y |
| Parent Organization Name | INFIRMARY MEDICAL CLINICS, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086X0206X |
Surgery Specialization: Surgical Oncology |
MD.24560 | AL | Allopathic & Osteopathic Physicians |
| Street Address |
3 MOBILE INFIRMARY CIR SUITE 305 |
| City | MOBILE |
| State | AL |
| Zip Code | 36607-3520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364802 | Mobile Infirmary Association | General Acute Care Hospital | 3 Mobile Infirmary Cir, Mobile, AL 36607-3520 | 2005-05-31 |
| 1205480183 | Claudia Fantucci | Nurse Practitioner | 3 Mobile Infirmary Cir, Suite 212, Mobile, AL 36607 | 2019-07-29 |
| 1235653742 | Jessica Danielle Gates | Nurse Practitioner | 3 Mobile Infirmary Cir, Mobile, AL 36607-3520 | 2017-07-27 |
| 1578934899 | Joel Andrew James Miller | Nurse Practitioner | 3 Mobile Infirmary Cir, Suite 308, Mobile, AL 36607-3520 | 2015-10-13 |
| 1275941601 | Kara Elliott Boutwell | Nurse Practitioner | 3 Mobile Infirmary Cir, Suite 302b, Mobile, AL 36607-3520 | 2014-07-29 |
| 1104261973 | Jennifer Nicole Saizan | Nurse Practitioner | 3 Mobile Infirmary Cir, Suite 410, Mobile, AL 36607-3520 | 2013-05-06 |
| 1780939793 | Enoch M Toler | Obstetrics & Gynecology | 3 Mobile Infirmary Cir, Suite 303, Mobile, AL 36607-3520 | 2012-07-16 |
| 1881987014 | Barry Dale Ballard Jr. | Surgery | 3 Mobile Infirmary Cir, Suite 212, Mobile, AL 36607-3520 | 2011-05-20 |
| 1982922167 | Jill Loftin Hawkins | Nurse Practitioner | 3 Mobile Infirmary Cir, Suite 212, Mobile, AL 36607-3520 | 2010-05-12 |
| 1710118666 | Rachael Jones Rutledge | Nurse Practitioner | 3 Mobile Infirmary Cir, Suite 212, Mobile, AL 36607-3520 | 2009-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821404559 | Cindy Strahan | Occupational Therapy Assistant | 2900 Sping Hill Ave, Mobile, AL 36607 | 2014-07-02 |
| 1043649072 | Rebecca Clara Eskridge | Speech-Language Pathologist | 200 C East Portier Ct., Mobile, AL 36607 | 2013-11-12 |
| 1497016794 | Gregory Mark Quatrino | Surgery | 3 Mobile Infirmary Cir Ste 212, Mobile, AL 36607 | 2012-06-03 |
| 1457682197 | Joseph Michael Mckean | Dentist | 3050 Dauphin Square Connector, Mobile, AL 36607 | 2010-01-20 |
| 1679711956 | Sheldon Scott Bradley | Nurse Practitioner | 1 Infirmary Circle, Mobile Infirmary Er, Mobile, AL 36607 | 2009-01-26 |
| 1508058132 | Wanda K Miller | Occupational Therapist | 1903 Springhill Ave, Mobile, AL 36607 | 2007-08-17 |
| 1811035322 | George N Lukes | Dentist | 2653a Old Shell Road, Mobile, AL 36607 | 2007-02-05 |
| 1487702999 | Carl Maltese | Specialist | 1901 Springhill Ave, Mobile, AL 36607 | 2007-01-08 |
| 1790871242 | Cheryl Lambert Thames | Physical Therapist | 2006 Airport Blvd., Mobile, AL 36607 | 2006-10-04 |
| 1760576227 | Jane Bagwell Hale | Physical Therapist | 3202 Old Shell Road, Mobile, AL 36607 | 2006-10-02 |
| Find all providers in zip 36607 | ||||
| Taxonomy Code | 2086X0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Oncology |
| A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research. |
| Notes: Source: Society of Surgical Oncology, 2007 [1/1/2008: definition added, source added, 7/1/2009: definiition reformatted] Additional Resources: http://www.surgonc.org/ ; American Board of Medical Specialties, 2007, www.abms.org ; American Board of Surgery, 2007, http://www.absurgery.org/ Surgical oncology is a recognized fellowship subspecialty program of surgery. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073765269 | Annabelle Leah Fonseca | Surgery | 1601 Center St Ste 2n, Mobile, AL 36604-1541 | 2008-10-21 |
| 1073171237 | Usa Health Physician Billing Services LLC | Surgery | 1601 Center St, Mobile, AL 36604-1541 | 2019-06-03 |
| 1306050109 | Joe Spencer Liles | Surgery | 1601 Center St, Ste 2n, Mobile, AL 36604-1512 | 2007-05-10 |
| 1376690339 | Cancer Surgery of Mobile, P.C. | Surgery | 3 Mobile Infirmary Cir, Ste 305, Mobile, AL 36607-3520 | 2007-01-04 |
| 1063479905 | Lee Walton Thompson | Surgery | 3 Mobile Infirmary Cir, Suite 305, Mobile, AL 36607-3520 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245650159 | Hannah Euphrates Woriax | Surgery | 619 19th St S, Birmingham, AL 35249-1838 | 2014-04-17 |
| 1689013005 | Jessica Marie Fazendin | Surgery | 619 19th St S, Birmingham, AL 35249 | 2013-06-19 |
| 1972846632 | Anna Mullenix Knight | Surgery | 800 Saint Vincents Dr Ste 640, Birmingham, AL 35205-1631 | 2013-04-01 |
| 1053639351 | Rachael Bramlett Lancaster | Surgery | 619 19th St S, Birmingham, AL 35249-1900 | 2010-05-11 |
| 1356668842 | Kristy Kummerow Broman | Surgery | 1720 University Blvd, Birmingham, AL 35233-1816 | 2010-04-23 |
| 1467563486 | Thomas N Wang | Surgery | 619 19th Street South, Birmingham, AL 35233 | 2006-08-31 |
| 1982626230 | Marshall M Urist | Surgery | 619 19th Street South, Birmingham, AL 35233 | 2006-07-24 |
| 1821026675 | Helen Krontiras | Surgery | 619 19th Street South, Birmingham, AL 35233 | 2006-06-29 |
| 1134156441 | Martin J Heslin | Surgery | 619 19th Street South, Birmingham, AL 35233 | 2006-06-26 |
| 1023053485 | Kertrisa R Mcwhite | Surgery | 4749 Berry Blvd, Montgomery, AL 36106-3079 | 2006-06-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.