Provider Demographics
NPI:1982083994
Name:VACCINATING ALABAMA KIDS IN SCHOOLS
Entity Type:Organization
Organization Name:VACCINATING ALABAMA KIDS IN SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-265-2464
Mailing Address - Street 1:1963 MEMORIAL PKWY SW
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5036
Mailing Address - Country:US
Mailing Address - Phone:256-265-2464
Mailing Address - Fax:256-265-2467
Practice Address - Street 1:1963 MEMORIAL PKWY SW
Practice Address - Street 2:SUITE 5
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5036
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:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty