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Organization
MONTGOMERY PEDIATRIC ASSOC, P.A.
Active
Organization
MONTGOMERY PEDIATRIC ASSOC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIKKI BERRY OFFICE MANAGER (OFFICE MANAGER)
(334) 260-9129
Entity
Organization
Contact information
Practice address
420 COTTON GIN RD, MONTGOMERY, AL 36117-3557
(334) 260-9129
(334) 260-9665
Mailing address
420 COTTON GIN RD, MONTGOMERY, AL 36117-3557
(334) 260-9129
(334) 260-9665
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
00006213
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528301770
—
AL
Enumeration date
05/08/2006
Last updated
04/15/2011
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