Organization
MADISON VALLEY PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY D YOUNG (OFFICE MANAGER)
(256) 461-0209
Entity
Organization
Contact information
Practice address
3809 SULLIVAN ST, STE 5, MADISON, AL 35758
(256) 461-0209
(256) 772-1506
Mailing address
3809 SULLIVAN ST, STE 5, MADISON, AL 35758
(256) 461-0209
(256) 772-1506
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20565
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659348019
DRJACQUELINE C GALES NPI
—
01
—
51000822
BLUE CROSS
AL
Enumeration date
10/03/2006
Last updated
08/22/2020
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