Pediatric Associates Of Alexander City Pc | |
21 Coosa County Road 50 Kellyton AL 35089-1900 | |
(256) 234-5021 | |
Not Available |
Full Name | Pediatric Associates Of Alexander City Pc |
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Speciality | Pediatrics |
Location | 21 Coosa County Road 50, Kellyton, Alabama |
Authorized Official Name and Position | Eric Owen Tyler (PRESIDENT) |
Authorized Official Contact | 2562345021 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Pediatric Associates Of Alexander City Pc Po Box 1269 Alexander City AL 35011-1269 Ph: (256) 234-5021 | Pediatric Associates Of Alexander City Pc 21 Coosa County Road 50 Kellyton AL 35089-1900 Ph: (256) 234-5021 |
NPI Number | 1952952541 |
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Provider Enumeration Date | 09/25/2019 |
Last Update Date | 09/25/2019 |
Medicare PECOS PAC ID | 9638168891 |
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Medicare Enrollment ID | O20191122000988 |
Identifier | Type | State | Issuer |
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1952952541 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |