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Organization

ADULT & PEDIATRIC MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEATHA BARBER MORGAN MD (VICE PRESIDENT)
(334) 284-9772
Entity
Organization

Contact information

Practice address
4825 VIRGINIA LOOP RD, MONTGOMERY, AL 36116
(334) 286-9772
(334) 284-9828
Mailing address
4825 VIRGINIA LOOP RD, MONTGOMERY, AL 36116
(334) 286-9772
(334) 284-9828

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000083670
AL
Enumeration date
07/11/2006
Last updated
07/01/2011
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