Decatur Pediatric Group, Pa in Clarkston - Pediatrics
Decatur Pediatric Group, Pa - NPI 1619029592
Decatur Pediatric Group, Pa is a Pediatrics in Clarkston, Georgia. Decatur Pediatric Group, Pa practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Decatur Pediatric Group, Pa is 1619029592. The last update date is 2020-08-22.
Decatur Pediatric Group, Pa's current location address is 4112 E Ponce De Leon Ave, Clarkston, Georgia. You can contact this provider via phone number 4042967133 and fax number 4042967211. The mailing address for Decatur Pediatric Group, Pa is 4112 E Ponce De Leon Ave, Clarkston, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Decatur Pediatric Group, Pa |
|---|---|
| Address | 4112 E Ponce De Leon Ave, Clarkston, Georgia |
| Phone Number | 4042967133 |
| Fax Number | 4042967211 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Wilson-Phillips R Lynette |
| Credentials | M.D. |
| Telephone Number | 4042967133 |
NPI Number Detail
| NPI Number | 1619029592 |
|---|---|
| Provider Enumeration Date | 2007-01-18 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 4112 E Ponce De Leon Ave |
|---|---|
| City | Clarkston |
| State | Georgia (GA) |
| Post Code | 300211817 |
| Phone Number | 4042967133 |
| Fax Number | 4042967211 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 208000000X |
| Licence No | 38132 |
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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 |
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Post Comment/ Review Below
What is the unique 10-digit identification code issued to Decatur Pediatric Group, Pa by the Centers for Medicare & Medicaid Services?
The Decatur Pediatric Group, Pa has been assigned the NPI (National Provider Identifier) 1619029592 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Decatur Pediatric Group, Pa is geographically located?
The Decatur Pediatric Group, Pa is physically situated at the following location: 4112 E Ponce De Leon Ave, Clarkston, GA, 300211817.
What is the area of specialization for Decatur Pediatric Group, Pa, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Decatur Pediatric Group, Pa is Pediatrics, and the corresponding taxonomy code that categorizes this area of expertise is 208000000X.
On what date did the Decatur Pediatric Group, Pa receive its 1619029592 assignment from the Centers for Medicare & Medicaid Services?
The Decatur Pediatric Group, Pa was assigned its 1619029592 by the Centers for Medicare & Medicaid Services on 2007-01-18.
When was the Decatur Pediatric Group, Pa's information last updated?
The Decatur Pediatric Group, Pa's information was last updated on 2020-08-22.