Provider Demographics
NPI:1922246842
Name:HUNTSVILLE PEDIATRIC ASSOCIATES, LLC
Entity Type:Organization
Organization Name:HUNTSVILLE PEDIATRIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2562-652-4104
Mailing Address - Street 1:1963 MEMORIAL PKWY.
Mailing Address - Street 2:STE 5
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801
Mailing Address - Country:US
Mailing Address - Phone:256-265-2464
Mailing Address - Fax:256-265-2467
Practice Address - Street 1:1963 MEMORIAL PKWY.
Practice Address - Street 2:STE 5
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801
Practice Address - Country:US
Practice Address - Phone:256-265-2464
Practice Address - Fax:256-265-2467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20726208000000X
AL24555208000000X
AL25009208000000X
AL10983208000000X
AL17519208000000X
AL17492208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty