Jefferson Park Pediatrics P C in Fort Wayne - Specialist
Jefferson Park Pediatrics P C - NPI 1629263181
Jefferson Park Pediatrics P C is a Specialist in Fort Wayne, Indiana. Jefferson Park Pediatrics P C practices all healthcare services and medical treatments related to Specialist. The NPI Number for Jefferson Park Pediatrics P C is 1629263181. The last update date is 2019-01-07.
Jefferson Park Pediatrics P C's current location address is 3919 W Jefferson Blvd Ste 1, Fort Wayne, Indiana. You can contact this provider via phone number 2604367722 and fax number 2604590012. The mailing address for Jefferson Park Pediatrics P C is 3919 W Jefferson Blvd Ste 1, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Jefferson Park Pediatrics P C |
|---|---|
| Address | 3919 W Jefferson Blvd Ste 1, Fort Wayne, Indiana |
| Phone Number | 2604367722 |
| Fax Number | 2604590012 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Veerula Rao Giridhar |
| Credentials | MD |
| Telephone Number | 2604367722 |
NPI Number Detail
| NPI Number | 1629263181 |
|---|---|
| Provider Enumeration Date | 2007-09-07 |
| Last Updated Date | 2019-01-07 |
Provider Mailing Address Detail
| Address | 3919 W Jefferson Blvd Ste 1 |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468046811 |
| Phone Number | 2604367722 |
| Fax Number | 2604590012 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 200262620 | IN | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jefferson Park Pediatrics P C by the Centers for Medicare & Medicaid Services?
The Jefferson Park Pediatrics P C has been assigned the NPI (National Provider Identifier) 1629263181 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Jefferson Park Pediatrics P C is physically located?
The Jefferson Park Pediatrics P C is physically situated at the following address: 3919 W Jefferson Blvd Ste 1, Fort Wayne, IN, 468046811.
What is the Jefferson Park Pediatrics P C's area of specialization and corresponding taxonomy classification?
The Jefferson Park Pediatrics P C's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
When did the Jefferson Park Pediatrics P C receive its 1629263181?
The Jefferson Park Pediatrics P C was issued its 1629263181 on 2007-09-07, which is the date when the organization was assigned this unique identifier.
As of what date was the information regarding Jefferson Park Pediatrics P C, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jefferson Park Pediatrics P C, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2019-01-07.