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General NPI Number Information
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NPI Number | 1578776381
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Entity Type | Organization
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Legal Business Name | SOUTH GEORGIA PEDIATRIC AND ALLERGY CENTER
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3440 N VALDOSTA RD
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City | VALDOSTA
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State | GA
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Zip | 31602-1079
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Country | US
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Telephone | 229-247-2211
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Fax | 229-247-9313
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Provider Business Mailing Address
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Address Line | 3440 N VALDOSTA RD
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City | VALDOSTA
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State | GA
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Zip | 31602-1079
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Country | US
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Telephone | 229-247-2211
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Fax | 229-247-9313
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN JOSEPH ALVARADO
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Credential | MD
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Telephone | 229-247-2211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 037463
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 037463
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 048706
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 053436
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 037463
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 048706
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 053436
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License Number State | GA
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