OrganizationActive
Providence Healthcare Services
NPI 1164683595 · Gynecologic Oncology Physician · Daphne, AL
Provider details
- NPI number
- 1164683595
- Entity type
- Organization
- Primary specialty
- Gynecologic Oncology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Clark Christianson, President(251) 631-3574
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
29653 Anchor Cross Blvd
Daphne, AL 36526-9594
Phone: (251) 631-3490
Fax: (251) 631-3461
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 850489
Mobile, AL 36685-0489
Other names (DBA / former)
- Doing business as
- Providence Medical Group
Registry dates
- Enumerated
- 2008-06-18
- Last updated
- 2012-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.