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NPI Profile

NPI: 1760442164
Classification: Pediatrics - 2080A0000X
Entity Type: Organization

Specialization: Adolescent Medicine

CLIA Number: 01D0300671

1621 11TH AVE S
ZIP 35205
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Phone: (205) 930-9500

MAGNOLIA PEDIATRICS SOUTH INC is an adolescent medicine pediatrics in Birmingham, 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 PEDIATRICS SOUTH INC NPI is 1760442164. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1621 11TH AVE S
ZIP 35205-703
Phone: (205) 930-9500

The provider's authorized official is Paul Amamoo .
The authorized official title is Sect-treasurer and has the following contact phone number (205) 930-9500.

The CLIA number assigned to this NPI record is 01D0300671 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 3/28/2006 and was last updated on 7/8/2007.

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 MedicineYes

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: 11/24/2020

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.