Healthcare Provider Details

I. General information

NPI: 1982083994
Provider Name (Legal Business Name): VACCINATING ALABAMA KIDS IN SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1963 MEMORIAL PKWY SW SUITE 5
HUNTSVILLE AL
35801-5036
US

IV. Provider business mailing address

1963 MEMORIAL PKWY SW SUITE 5
HUNTSVILLE AL
35801-5036
US

V. Phone/Fax

Practice location:
  • Phone: 256-265-2464
  • Fax: 256-265-2467
Mailing address:
  • Phone: 256-265-2464
  • Fax: 256-265-2467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TIMOTHY ANDREW STEWART
Title or Position: PHYSICIAN
Credential: MD
Phone: 256-265-2464