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Organization
GULF SHORES PEDIATRICS PC
Active
Organization
GULF SHORES PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN C LAVLIE MD (BUSINESS PRESIDENT)
(251) 968-2323
Entity
Organization
Contact information
Practice address
232 OFFICE PARK DR., GULF SHORES, AL 36542
(251) 968-2323
(251) 968-2624
Mailing address
232 OFFICE PARK DR., GULF SHORES, AL 36542
(251) 968-2323
(251) 968-2624
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22320
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39807
BCBS
AL
Enumeration date
07/24/2006
Last updated
08/22/2020
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