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Organization
PEDIATRIC PREVENTATIVE MEDICAL SERVICES
Active
Organization
PEDIATRIC PREVENTATIVE MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY HOLDEN JONES MD (MEDICAL DIRECTOR)
(205) 552-8691
Entity
Organization
Contact information
Practice address
6869 5TH AVE S, BIRMINGHAM, AL 35212-1866
(205) 833-9000
(205) 838-2073
Mailing address
6869 5TH AVE S, BIRMINGHAM, AL 35212-1866
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
30125
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156044
—
AL
Enumeration date
08/20/2015
Last updated
08/20/2015
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