Provider Demographics
NPI:1699914770
Name:DEMOPOLIS PEDIATRICS
Entity type:Organization
Organization Name:DEMOPOLIS PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MILTON S. BRASFIELD, III, M. D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRASFIELD
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:334-289-5770
Mailing Address - Street 1:105 US HIGHWAY 80 E
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DEMOPOLIS
Mailing Address - State:AL
Mailing Address - Zip Code:36732-3605
Mailing Address - Country:US
Mailing Address - Phone:334-289-5770
Mailing Address - Fax:334-289-5758
Practice Address - Street 1:105 US HIGHWAY 80 E
Practice Address - Street 2:SUITE 205
Practice Address - City:DEMOPOLIS
Practice Address - State:AL
Practice Address - Zip Code:36732-3605
Practice Address - Country:US
Practice Address - Phone:334-289-5770
Practice Address - Fax:334-289-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty