| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 09/25/2019 |
| Last Update Date | 09/25/2019 |
| Medicare PECOS PAC ID | 9638168891 |
|---|---|
| Medicare Enrollment ID | O20191122000988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952952541 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |