Provider Demographics
NPI:1528328127
Name:INFIRMARY HEALTH URGENT CARE - GULF SHORES, P.C.
Entity type:Organization
Organization Name:INFIRMARY HEALTH URGENT CARE - GULF SHORES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-5737
Mailing Address - Street 1:1140 GULF SHORES PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-5914
Mailing Address - Country:US
Mailing Address - Phone:251-968-2273
Mailing Address - Fax:251-948-4860
Practice Address - Street 1:1140 GULF SHORES PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-5914
Practice Address - Country:US
Practice Address - Phone:251-968-2273
Practice Address - Fax:251-948-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
102G704054Medicare PIN