MAGNOLIA COMMONS PEDIATRICS LLC NPI 1013280486

NPI Information

  • NPI: 1013280486
  • Provider Name: MAGNOLIA COMMONS PEDIATRICS LLC
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Organization
  • Doing Business As: CARLILE PEDIATRICS
  • CLIA Number: 01D2160778
  • Address: 78 CAMBRIDGE CT
    WETUMPKA, AL
    ZIP 36093
  • Phone: (334) 567-4311

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NPI Details

MAGNOLIA COMMONS PEDIATRICS LLC is an adolescent medicine pediatrics in Wetumpka, AL. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. MAGNOLIA COMMONS PEDIATRICS LLC NPI is 1013280486. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Carlile Pediatrics.

The provider's business location address is:

78 CAMBRIDGE CT
WETUMPKA, AL
ZIP 36093-259
Phone: (334) 567-4311
Fax: (334) 567-4312

The provider's authorized official is Michael D Bruce .
The authorized official title is Ceo and has the following contact phone number (334) 567-4311.

The CLIA number assigned to this NPI record is 01D2160778 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/16/2012 and was last updated on 2/16/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent Medicine19637ALABAMAYes

What is NPI?

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This page was last updated on: 3/30/2025

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