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General NPI Number Information
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NPI Number | 1508047697
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Entity Type | Organization
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Legal Business Name | NAKI PEDIATRICS & ADOLESCENT
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Dates
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Enumeration Date | 11/17/2007
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 410 BAY ST
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City | GADSDEN
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State | AL
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Zip | 35901-5108
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Country | US
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Telephone | 256-543-0111
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Fax | 256-543-2907
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Provider Business Mailing Address
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Address Line | 410 BAY ST NAKI PEDIATRICS & ADOLESCENT HEALTH CENTER, PC
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City | GADSDEN
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State | AL
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Zip | 35901-0000
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Country | US
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Telephone | 256-543-0111
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Fax | 256-543-2907
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER KIRYA
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Credential | MD
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Telephone | 256-543-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 8282
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License Number State | AL
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