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General NPI Number Information
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NPI Number | 1811523137
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Entity Type | Organization
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Legal Business Name | TLC PEDIATRICS & FAMILY LLC
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Dates
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Enumeration Date | 03/18/2020
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 22335 US HIGHWAY 72 STE C SUITE C
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City | ATHENS
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State | AL
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Zip | 35613-2611
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Country | US
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Telephone | 256-585-5626
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Fax | 256-870-4112
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Provider Business Mailing Address
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Address Line | 22335 US HIGHWAY 72 STE C SUITE C
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City | ATHENS
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State | AL
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Zip | 35613-2611
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Country | US
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Telephone | 256-870-4111
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Fax | 256-870-4112
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Authorized Official
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Title or Position | OWNER/CRNP
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Name | TEAIRAH WILDER
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Credential | CRNP
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Telephone | 256-870-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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