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EASTERN SHORE CHILDREN'S CLINIC P.C. NPI 1447614854


NPI Information

NPI: 1447614854
Provider Name: EASTERN SHORE CHILDREN'S CLINIC, P.C.
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 01D0902104

Address:
9603 STAGECOACH COMMERCIAL PARK CIRCLE
SPANISH FORT, AL
ZIP 36527
Phone: (251) 928-0624
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EASTERN SHORE CHILDREN'S CLINIC, P.C. is a pediatrics in Spanish Fort, AL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. EASTERN SHORE CHILDREN'S CLINIC, P.C. NPI is 1447614854. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

9603 STAGECOACH COMMERCIAL PARK CIRCLE
SPANISH FORT, AL
ZIP 36527
Phone: (251) 928-0624

The provider's authorized official is Henry Elliot Lee .
The authorized official title is Office Manager and has the following contact phone number (251) 928-0624.

The CLIA number assigned to this NPI record is 01D0902104 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/12/2016 and was last updated on 4/19/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14018429MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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