Provider Demographics
NPI:1427032804
Name:BRIGHTSTARTS PEDIATRICS PC
Entity Type:Organization
Organization Name:BRIGHTSTARTS PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN & SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:JITENDRA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-461-8442
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-5417
Mailing Address - Country:US
Mailing Address - Phone:256-461-8442
Mailing Address - Fax:256-461-8447
Practice Address - Street 1:3776 SULLIVAN ST
Practice Address - Street 2:SUITE C
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2371
Practice Address - Country:US
Practice Address - Phone:256-461-8442
Practice Address - Fax:256-461-8447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL092226261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center