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Contact Information

KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE
119 STEPHEN J WHITE MEMORIAL BLVD
TALLADEGA, AL35160-2106
 Phone: 256-268-7775
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KIDS CLINIC PEDIATRIC AND ADOLESCENT MEDICINE · (Female)

NPI Number 1154810224
Status Active
Credentials
Entity Individual
Enumeration date 05/04/2018
Last updated 09/26/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • AL Medicaid 000032739
  • Other G50661 UPIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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