Organization
EASTERN SHORE CHILDREN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY ELLIOT LEE (OFFICE MANAGER)
(251) 928-0624
Entity
Organization
Contact information
Practice address
150 S INGLESIDE ST, SUITE 7, FAIRHOPE, AL 36532-1803
(251) 928-0624
(251) 928-0655
Mailing address
PO BOX 989, FAIRHOPE, AL 36533-0989
(251) 928-0624
(251) 928-0655
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000810930
—
AL
Enumeration date
04/03/2006
Last updated
04/19/2022
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