Organization
WILLOW TREE PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEIDI BLAIR MD (PROVIDER/OWNER)
(256) 708-6143
Entity
Organization
Contact information
Practice address
2108 AL HIGHWAY 157, CULLMAN, AL 35058-0656
(256) 735-4632
(256) 735-4639
Mailing address
1641 EDGEWOOD ST NW, CULLMAN, AL 35055-5739
(256) 708-6143
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
19923
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138096
—
AL
Enumeration date
12/05/2017
Last updated
03/17/2018
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