Healthcare Provider Details

I. General information

NPI: 1942655758
Provider Name (Legal Business Name): ACTS OF KIDNESS PEDIATRICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2016
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

861 N HIGLEY RD SUITE B101
GILBERT AZ
85234-9602
US

IV. Provider business mailing address

861 N HIGLEY RD SUITE B101
GILBERT AZ
85234-9602
US

V. Phone/Fax

Practice location:
  • Phone: 480-664-6400
  • Fax:
Mailing address:
  • Phone: 480-664-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number41887
License Number StateAZ

VIII. Authorized Official

Name: ALISON L WILCOCK
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 480-664-6400