Provider Demographics
NPI:1861530776
Name:TWICKENHAM PEDIATRICS
Entity type:Organization
Organization Name:TWICKENHAM PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:MURIEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DESIMONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-533-1030
Mailing Address - Street 1:115 MANNING DR SW
Mailing Address - Street 2:SUITE A101
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4315
Mailing Address - Country:US
Mailing Address - Phone:256-533-1030
Mailing Address - Fax:256-533-1043
Practice Address - Street 1:115 MANNING DR SW
Practice Address - Street 2:SUITE A101
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4315
Practice Address - Country:US
Practice Address - Phone:256-533-1030
Practice Address - Fax:256-533-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty