Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lakeshore Pediatrics PC

Organization Pediatrics Physician · NPI 1588002455

Lakeshore Pediatrics PC is a Pediatrics Physician in Moulton, Alabama. Registered with an NPI since 2013.

In the registry since
2013
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

12521 Al Highway 157 Ste B
Moulton, AL 35650-1937
Phone: (256) 974-6300
Fax: (256) 974-6333
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1588002455
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Agustin Rivas — President · (256) 386-4151
NPI enumeratedJune 12, 2013
Last updated in NPPESJune 12, 2013
Mailing address1120 S Jackson Hwy Ste 304, Sheffield, AL 35660-5773