Organization
FORT PAYNE PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER STROGOV M.D. (PRESIDENT)
(256) 997-5900
Entity
Organization
Contact information
Practice address
1359 OLD WATER WORKS RD SW, FORT PAYNE, AL 35968-3347
(256) 997-5900
(256) 997-5995
Mailing address
1359 OLD WATER WORKS RD SW, FORT PAYNE, AL 35968-3347
(256) 997-5900
(256) 997-5995
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167395
—
AL
05
—
177834
—
AL
Enumeration date
10/23/2014
Last updated
08/08/2023
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