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General NPI Number Information
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NPI Number | 1912748914
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Entity Type | Organization
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Legal Business Name | BAY MINETTE PEDIATRICS
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 2305 HAND AVE STE 1
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City | BAY MINETTE
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State | AL
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Zip | 36507-4198
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Country | US
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Telephone | 251-239-8198
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Fax | 251-239-8183
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Provider Business Mailing Address
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Address Line | 2305 HAND AVE STE 1
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City | BAY MINETTE
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State | AL
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Zip | 36507-4198
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Country | US
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Telephone | 251-239-8198
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Fax | 251-239-8183
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BRITTANY JOINER
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Credential |
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Telephone | 251-239-8198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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