Organization
PEDIATRIC ASSOCIATES OF ALEXANDER CITY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC OWEN TYLER (PRESIDENT)
(256) 234-5021
Entity
Organization
Contact information
Practice address
21 COOSA COUNTY ROAD 50, KELLYTON, AL 35089-1900
(256) 234-5021
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
Enumeration date
09/25/2019
Last updated
09/25/2019
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