Provider Demographics
NPI:1285960674
Name:JUST KIDZ MEDICAL LLC
Entity type:Organization
Organization Name:JUST KIDZ MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:AWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-382-1878
Mailing Address - Street 1:PO BOX 82229
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36689-2229
Mailing Address - Country:US
Mailing Address - Phone:251-382-1878
Mailing Address - Fax:888-229-2558
Practice Address - Street 1:5466 OLD SHELL RD
Practice Address - Street 2:STE. A
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3046
Practice Address - Country:US
Practice Address - Phone:251-382-1878
Practice Address - Fax:888-229-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-20
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL169712080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty