Organization
ABC PEDIATRIC CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA KAREN JOINES M.D. (OWNER)
(256) 734-3759
Entity
Organization
Contact information
Practice address
1900 MAIN AVE SW, CULLMAN, AL 35055-7200
(256) 734-3759
(256) 734-9764
Mailing address
1900 MAIN AVE SW, CULLMAN, AL 35055-7200
(256) 734-3759
(256) 734-9764
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
00023029
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009923945
—
AL
Enumeration date
06/20/2007
Last updated
06/04/2008
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