| Pediatric Associates Of Alexander City Pc | |
|
1962 Cherokee Rd Alexander City AL 35010-3437 | |
| (256) 234-5021 | |
| (256) 234-5640 |
| Full Name | Pediatric Associates Of Alexander City Pc |
|---|---|
| Speciality | Pediatrics |
| Location | 1962 Cherokee Rd, Alexander City, Alabama |
| Authorized Official Name and Position | Eric Owen Tyler (PRESIDENT/CEO) |
| Authorized Official Contact | 2562345021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pediatric Associates Of Alexander City Pc Po Box 1269 Alexander City AL 35011-1269 Ph: (256) 234-5021 | Pediatric Associates Of Alexander City Pc 1962 Cherokee Rd Alexander City AL 35010-3437 Ph: (256) 234-5021 |
| NPI Number | 1144284084 |
|---|---|
| Provider Enumeration Date | 04/17/2006 |
| Last Update Date | 09/25/2019 |
| Medicare PECOS PAC ID | 9638168891 |
|---|---|
| Medicare Enrollment ID | O20190914000184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144284084 | NPI | - | NPPES |
| 528501050 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
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