Healthcare Provider Details

I. General information

NPI: 1700963345
Provider Name (Legal Business Name): THE CHILDREN'S HOSPITAL OF ALABAMA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CAHABA RD SUITE 102
BIRMINGHAM AL
35223-2623
US

IV. Provider business mailing address

3300 CAHABA RD SUITE 102
BIRMINGHAM AL
35223-2623
US

V. Phone/Fax

Practice location:
  • Phone: 205-870-7292
  • Fax: 205-870-3639
Mailing address:
  • Phone: 205-870-7292
  • Fax: 205-870-3639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAWN WALTON
Title or Position: CFO
Credential:
Phone: 205-638-9901