Organization
MARSHALL COUNTY PEDIATRICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKY HICKS (PRACTICE MANAGEMENT)
(256) 891-5102
Entity
Organization
Contact information
Practice address
2525 US HIGHWAY 431, STE 104, BOAZ, AL 35957-5934
(256) 571-8969
(256) 571-8980
Mailing address
45 MEDICAL PARK DR, SUITE B, GUNTERSVILLE, AL 35976-6999
(256) 571-8969
(256) 571-8980
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6719
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508935545
NPI
AL
Enumeration date
06/30/2008
Last updated
06/30/2008
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