| Organization Name: | MARSHALL MEDICAL CENTER NORTH JONES PEDIATRIC PRACTICE |
| NPI Number: | 1003008376 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VICKY R HICKS (DIRECTOR - PM) |
| Mailing Address: | 45 Medical Park Dr B Guntersville |
| State: | AL US |
| Postal Code: | 359765766 |
| Phone Number: | 2565718969 |
| Fax Number: | 2565718980 |
| NPI Enumeration Date: | 08/10/2007 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 26482 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |