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LAKESHORE PEDIATRICS OF RUSSELLVILLE
NPI 1194907394
Pediatrics in Russellville, AL

Active since November 29, 2007
603 GANDY ST NE, RUSSELLVILLE, AL 35653(256) 331-5055(256) 383-7293 Get Directions Write a Review

NPPES record last updated: November 29, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lakeshore Pediatrics Of Russellville NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESHORE PEDIATRICS OF RUSSELLVILLE (NPI 1194907394) is a healthcare organization registered as a pediatrics in Russellville, Alabama and active in the NPI registry since November 2007. The organization lists Agustin Rivas, Owner, as its authorized official.

NPPES Registry Identity

NPI1194907394
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameLAKESHORE PEDIATRICS OF RUSSELLVILLE
Location Address603 GANDY ST NERussellville, AL 35653-1911
Mailing Address1120 S Jackson Hwy, Suite 304Sheffield, AL 35660-5777 · (256) 386-4151 · Fax (256) 383-7293
Phone(256) 331-5055
Fax(256) 383-7293
Organization SubpartNo
Authorized OfficialAgustin RivasOwner · (256) 386-4151
Enumeration DateNovember 29, 2007
✔ NPI 1194907394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AL · 2006323
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
603 GANDY ST NE, Russellville, AL 35653
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAKESHORE PEDIATRICS OF RUSSELLVILLE, PC
Clinic/Center (Rural Health)
603 GANDY ST NE
RUSSELLVILLE, AL 35653
Franklin County (256) 331-5055

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lakeshore Pediatrics Of Russellville's NPI number?

The NPI number for Lakeshore Pediatrics Of Russellville is 1194907394. It was assigned to this organization in the NPPES registry on November 29, 2007.

Where is Lakeshore Pediatrics Of Russellville located?

Lakeshore Pediatrics Of Russellville is located at 603 Gandy St NE, Russellville, AL 35653. The listed phone number is (256) 331-5055.

What is Lakeshore Pediatrics Of Russellville's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Lakeshore Pediatrics Of Russellville was last updated on November 29, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.