Healthcare Provider Details

I. General information

NPI: 1669643789
Provider Name (Legal Business Name): CHELSEA PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

194 NARROWS DR SUITE 104
BIRMINGHAM AL
35242-8667
US

IV. Provider business mailing address

194 NARROWS DR SUITE 104
BIRMINGHAM AL
35242-8667
US

V. Phone/Fax

Practice location:
  • Phone: 205-981-2728
  • Fax: 205-981-2729
Mailing address:
  • Phone: 205-981-2728
  • Fax: 205-981-2729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25409
License Number StateAL

VIII. Authorized Official

Name: DR. ALICE M HARDY
Title or Position: OWNER
Credential: M.D.
Phone: 205-981-2728