Provider Demographics
NPI:1669643789
Name:CHELSEA PEDIATRICS, INC.
Entity Type:Organization
Organization Name:CHELSEA PEDIATRICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-981-2728
Mailing Address - Street 1:194 NARROWS DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-8667
Mailing Address - Country:US
Mailing Address - Phone:205-981-2728
Mailing Address - Fax:205-981-2729
Practice Address - Street 1:194 NARROWS DR
Practice Address - Street 2:SUITE 104
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-8667
Practice Address - Country:US
Practice Address - Phone:205-981-2728
Practice Address - Fax:205-981-2729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25409208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51519854OtherBCBS
AL529918920Medicaid