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General NPI Number Information
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NPI Number | 1366146904
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Entity Type | Organization
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Legal Business Name | EQUAL JUSTICE INITIATIVE
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 421 ST. LUKE'S DRIVE
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City | MONTGOMERY
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State | AL
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Zip | 36117
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Country | US
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Telephone | 334-239-9740
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Fax | 334-239-9749
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Provider Business Mailing Address
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Address Line | 122 COMMERCE ST
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City | MONTGOMERY
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State | AL
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Zip | 36104-2538
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Country | US
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Telephone | 334-269-1803
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARGARET HAYDEN
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Credential | MD
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Telephone | 334-239-9740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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