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Organization

PEDIATRIC ASSOCIATES OF ALEXANDER CITY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC OWEN TYLER M.D. (PRESIDENT/CEO)
(256) 234-5021
Entity
Organization

Contact information

Practice address
1962 CHEROKEE RD, ALEXANDER CITY, AL 35010-3437
(256) 234-5021
(256) 234-5640
Mailing address
PO BOX 1269, ALEXANDER CITY, AL 35011-1269
(256) 234-5021
(256) 234-5640

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
261QR1300X
Rural Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
528501050
AL
Enumeration date
04/17/2006
Last updated
09/25/2019
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