FORT PAYNE PEDIATRICS LLC NPI 1356746085

NPI Information

FORT PAYNE PEDIATRICS, LLC is a rural health clinic center in Fort Payne, AL. FORT PAYNE PEDIATRICS, LLC NPI is 1356746085. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1359 OLD WATER WORKS RD SW
FORT PAYNE, AL
ZIP 35968-347
Phone: (256) 997-5900
Fax: (256) 997-5995

The provider's authorized official is Peter Strogov .
The authorized official title is President and has the following contact phone number (256) 997-5900.

The CLIA number assigned to this NPI record is 01D2193383 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/23/2014 and was last updated on 8/8/2023.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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