NPIMap

Gene Kay Cheng, M.D.

Individual provider Active NPI Pediatric Adolescent Medicine Physician · Moulton, AL

NPI 1164458253 · NPPES record last updated May 16, 2008

Key facts

NPI
1164458253
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Adolescent Medicine Physician 2080A0000X
License
00020656 (AL)
Practice address
10939 Al Highway 157
Moulton, AL 35650-1900
Phone
(256) 974-3390
Fax
(256) 905-0261
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00020656ALMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: genekay.cheng@attmoul.direct.medconnect-inc.com
  • Direct secure messaging: gcheng@yourcarecommunity.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 00020656 AL Yes

Addresses

Primary practice location

10939 Al Highway 157
Moulton, AL 35650-1900

Mailing address

PO Box 340
Moulton, AL 35650-0340
Phone (256) 974-3390

Other identifiers

IdentifierTypeStateIssuer
540003994MedicaidAL
543994004MedicaidAL

Other providers in Moulton, AL

All providers in Moulton, AL · Pediatric Adolescent Medicine Physician in Alabama

Sources for this page

Verify at the official NPI Registry.