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General NPI Number Information
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NPI Number | 1881754042
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Entity Type | Individual
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Provider Name | JAVIER E REPETTO M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 809 UNIVERSITY BLVD E
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City | TUSCALOOSA
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State | AL
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Zip | 35401-2029
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Country | US
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Telephone | 205-333-4656
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Fax | 205-333-4660
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Provider Business Mailing Address
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Address Line | 10250 LAKE SIDE DR
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City | TUSCALOOSA
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State | AL
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Zip | 35406-5007
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Country | US
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Telephone | 205-333-4656
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Fax | 205-333-4660
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 22708
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License Number State | AL
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