FORT PAYNE PEDIATRICS LLC

FORT PAYNE, AL
NPI1033477393
Other NameFT PAYNE PEDIATRICS,LLC
Entity TypeOrganization
Authorized ContactPETER STROGOV
Physician/Owner
256-997-5900
Organization Subpart ?No
Primary Taxonomy261QR1300X Clinic/Center, Rural Health
(Licence: AL  01-8910)
Additional Taxonomies208000000X Pediatrics
(Licence: AL  30426)
363LF0000X Nurse Practitioner, Family
(Licence: AL  1-075895)
363LF0000X Nurse Practitioner, Family
(Licence: AL  1-087445)
Enumeration Date2012-04-24
Last Update Date2014-03-31
Business Address
FORT PAYNE PEDIATRICS LLC
1906 GLENN BLVD SW STE 100A
FORT PAYNE, AL 35968-3546
Phone number: 256-997-5900
Mailing Address
FORT PAYNE PEDIATRICS LLC
1906 GLENN BLVD SW STE 100A
FORT PAYNE, AL 35968-3546
Phone number: 256-997-5900