Healthcare Provider Details

I. General information

NPI: 1093731242
Provider Name (Legal Business Name): COVINGTON PEDIATRICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 W BYPASS
ANDALUSIA AL
36420-4731
US

IV. Provider business mailing address

614 W BYPASS
ANDALUSIA AL
36420-4731
US

V. Phone/Fax

Practice location:
  • Phone: 334-222-3555
  • Fax:
Mailing address:
  • Phone: 334-222-3555
  • Fax: 334-222-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GABRIELLE BALDWIN
Title or Position: OWNER
Credential: M.D.
Phone: 334-222-3555