Healthcare Provider Details

I. General information

NPI: 1639718562
Provider Name (Legal Business Name): KIDS R US PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2019
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 GOLFVIEW DR NE
ARAB AL
35016-5473
US

IV. Provider business mailing address

121 GOLFVIEW DR NE
ARAB AL
35016-5473
US

V. Phone/Fax

Practice location:
  • Phone: 256-931-5437
  • Fax: 833-753-1386
Mailing address:
  • Phone: 256-931-5437
  • Fax: 833-753-1386

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. TONYA RENEE MILLER
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 256-931-5437