SOUTHERN CANCER CENTER, PC (NPI# 1578629556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578629556 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CANCER CENTER, PC |
| Practice Address |
6701 Airport Blvd Mobile AL 36608-6705 |
| Mailing Address |
29653 Anchor Cross Blvd Daphne AL 36526-9594 |
| Practice Telephone | 2516256896 |
| Practice Fax Number | 2516313209 |
| Mailing Telephone | 2516256896 |
| Mailing Fax Number | 2516256897 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2018-09-24 |
| Authorized Official Name | LAUREN PETTIS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2516256896 |
| Authorized Official Credential | RN/OCN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| Street Address |
6701 AIRPORT BLVD |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-6705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053313312 | Richard O Nenstiel | Physician Assistant | 6701 Airport Blvd, Suite D146, Mobile, AL 36608 | 2005-06-01 |
| 1508392432 | University of South Alabama Health Care Authority | Internal Medicine | 6701 Airport Blvd, A101, Mobile, AL 36608-6705 | 2017-05-11 |
| 1093241671 | Alabama Providence Healthcare Services | Otolaryngology | 6701 Airport Blvd, Suite B123, Mobile, AL 36608-6705 | 2017-05-03 |
| 1588109599 | Citrin Cardiology PC | Internal Medicine | 6701 Airport Blvd, Suite C138, Mobile, AL 36608-3784 | 2016-12-29 |
| 1629511753 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Ste B215, Mobile, AL 36608-6705 | 2016-11-21 |
| 1891245692 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite D143, Mobile, AL 36608-6705 | 2016-10-05 |
| 1386191740 | Leah Ambrose | Physician Assistant | 6701 Airport Blvd, Suite C138, Mobile, AL 36608-6705 | 2016-09-02 |
| 1386093953 | Terra Lynn Parnell | Nurse Practitioner | 6701 Airport Blvd, Suite D-330, Mobile, AL 36608 | 2016-06-06 |
| 1649634395 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite A-t06, Mobile, AL 36608-6705 | 2016-04-08 |
| 1558725200 | Alabama Providence Healthcare Services | Specialist | 6701 Airport Blvd, Suite B329, Mobile, AL 36608-6705 | 2016-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396787230 | Thomas Wayne Butler | Internal Medicine | 1660 Spring Hill Ave, Mobile, AL 36604-1405 | 2006-06-12 |
| 1982657755 | Connie D Uzel | Internal Medicine | 3719 Dauphin St Fl 5, Mobile, AL 36608-1753 | 2006-05-19 |
| 1780637579 | Thaddeus Beeker | Internal Medicine | 6701 Airport Blvd Bldg B, Mobile, AL 36608-6705 | 2006-05-19 |
| 1538112701 | Michael Wallace Meshad | Internal Medicine | 3719 Dauphin Street, 5th Floor, Mobile, AL 36608-1753 | 2006-05-18 |
| 1558353987 | Daniel G Cameron | Internal Medicine | 1660 Springhill Ave, Mobile, AL 36604-1405 | 2005-08-22 |
| 1487060489 | Kannan Thanikachalam | Internal Medicine | 1700 Spring Hill Ave, Mobile, AL 36604-1407 | 2014-07-10 |
| 1003255993 | Jose Nahun Galeas Soriano | Internal Medicine | 1700 Spring Hill Ave Ste 100, Mobile, AL 36604-1416 | 2013-06-24 |
| 1790098770 | Norma Carole Wiseman Norden | Internal Medicine | 1660 Spring Hill Ave, Mobile, AL 36604-1405 | 2010-07-20 |
| 1114166139 | William Riley Taylor | Internal Medicine | 1660 Springhill Ave, Mobile, AL 36604-1405 | 2009-02-14 |
| 1720239932 | Infirmary West Oncology and Infusion Services | Internal Medicine | 3 Mobile Infirmary Circle, Suite 301, Mobile, AL 36607-3515 | 2008-10-07 |
| Find all providers in MOBILE | ||||
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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.