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General NPI Number Information
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NPI Number | 1114025103
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Entity Type | Organization
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Legal Business Name | THE CHILDREN'S HOSPITAL OF ALABAMA
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 1600 7TH AVE S IRELAND CENTER-4TH FLOOR DEARTH
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1711
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Country | US
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Telephone | 205-638-9193
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Fax | 205-638-9949
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Provider Business Mailing Address
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Address Line | PO BOX 114070536
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City | BIRMINGHAM
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State | AL
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Zip | 35246-0536
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Country | US
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Telephone | 205-638-5600
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Fax | 205-638-5623
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Authorized Official
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Title or Position | CFO
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Name | DAWN WALTON
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Credential |
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Telephone | 205-638-9901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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