Healthcare Provider Details

I. General information

NPI: 1316379910
Provider Name (Legal Business Name): HB PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2013
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3957 HOLCOMB BRIDGE RD SUITE 100
NORCROSS GA
30092-5254
US

IV. Provider business mailing address

PO BOX 4367
MACON GA
31208-4367
US

V. Phone/Fax

Practice location:
  • Phone: 770-449-9334
  • Fax: 770-449-3181
Mailing address:
  • Phone: 770-449-9334
  • Fax: 770-449-3181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: GEORGE KATSITADZE
Title or Position: OWNER
Credential: MD
Phone: 770-923-6400