NPI | 1033477393 |
---|---|
Other Name | FT PAYNE PEDIATRICS,LLC |
Entity Type | Organization |
Authorized Contact | PETER STROGOV Physician/Owner 256-997-5900 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: AL 01-8910) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AL 30426) |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-075895) | |
363LF0000X Nurse Practitioner, Family (Licence: AL 1-087445) | |
Enumeration Date | 2012-04-24 |
Last Update Date | 2014-03-31 |