Organization · NPI-2

Abc Pediatrics West LLC

Family Medicine · Jasper, AL

NPI number1316714512
StatusActive
Last updated in NPPESDec 7, 2023

Details

NPI
1316714512
Entity type
Organization (NPI-2)
Legal business name
Abc Pediatrics West LLC
Organization subpart
No
Enumeration date
Dec 7, 2023
Certification date
Dec 7, 2023
Last updated
Dec 7, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Other names

  • Abc Pediatrics West (Doing Business As)

Practice location

400 19th St E
Jasper, AL 35501-5416

Phone 205-936-8107 · Fax 205-512-2548

Mailing address

400 19th St E
Jasper, AL 35501-5416

Phone 205-936-8107 · Fax 205-512-2548

Authorized official

Leah Varden Gann
Certified Rn Practitioner
2059368107

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in Jasper, AL