1124529870 NPI number — UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY PHYSICIAN BILLING CO

Table of content: MR. BILLY JOHN TIOSECO RN (NPI 1659070100)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124529870 NPI number — UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY PHYSICIAN BILLING CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF SOUTH ALABAMA HEALTH CARE AUTHORITY PHYSICIAN BILLING CO
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124529870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3929-1 AIRPORT BLVD
Provider Second Line Business Mailing Address:
5TH FLOOR, ROOM 513
Provider Business Mailing Address City Name:
MOBILE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-318-2681
Provider Business Mailing Address Fax Number:
251-378-6222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6701 AIRPORT BLVD STE A101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOBILE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36608-6767
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-633-8880
Provider Business Practice Location Address Fax Number:
251-378-6222
Provider Enumeration Date:
02/27/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MADISON
Authorized Official First Name:
ERICA
Authorized Official Middle Name:
Authorized Official Title or Position:
CREDENTIALING
Authorized Official Telephone Number:
251-318-2681

Provider Taxonomy Codes

  • Taxonomy code: 261QI0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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