Provider Demographics
NPI:1053393124
Name:MOBILE ORTHOPEDIC CENTER
Entity type:Organization
Organization Name:MOBILE ORTHOPEDIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-342-5053
Mailing Address - Street 1:PO BOX 70167
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36670-1167
Mailing Address - Country:US
Mailing Address - Phone:251-342-5053
Mailing Address - Fax:251-476-5460
Practice Address - Street 1:124 S UNIVERSITY BLVD
Practice Address - Street 2:#1-A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3088
Practice Address - Country:US
Practice Address - Phone:251-342-5053
Practice Address - Fax:251-476-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty