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NPI Verification

National Provider Identifier: 1073548004

Adult & Pediatric Medicine PC

Organization

Primary Specialty

Pediatrics

Code: 208000000X

All Specialties (2)

Family Medicine, Adult Medicine

Code: 207QA0505X

Pediatrics

Code: 208000000X

Primary

Practice Address

4825 VIRGINIA LOOP RD

MONTGOMERY, AL 36116

Phone: 334-286-9772

NPI Enumeration Date

July 11, 2006

NPI Number

1073548004

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry