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ETOWAH PEDIATRICS NPI 1972529808


NPI Information

NPI: 1972529808
Provider Name: ETOWAH PEDIATRICS
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 01D1048892

Address:
170 INDEPENDENT DR
RAINBOW CITY, AL
ZIP 35906
Phone: (256) 413-1467
Get Directions

ETOWAH PEDIATRICS is a pediatrics in Rainbow City, 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. ETOWAH PEDIATRICS NPI is 1972529808. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

170 INDEPENDENT DR
RAINBOW CITY, AL
ZIP 35906-286
Phone: (256) 413-1467
Fax: (256) 413-1470

The provider's authorized official is Benjamin Hester .
The authorized official title is Physician and has the following contact phone number (256) 413-1467.

The CLIA number assigned to this NPI record is 01D1048892 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 8/28/2014.


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
1208000000XPediatrics23664ALABAMAYes

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
1G90422MEDICARE UPINALABAMA
2529926830MEDICAIDALABAMA

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: 11/14/2023

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