Healthcare Provider Details

I. General information

NPI: 1740381441
Provider Name (Legal Business Name): CHILDREN'S CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 RIVER DRIVE
IRVINE KY
40336-1331
US

IV. Provider business mailing address

223 RIVER DR
IRVINE KY
40336-1142
US

V. Phone/Fax

Practice location:
  • Phone: 606-723-5142
  • Fax: 606-723-3798
Mailing address:
  • Phone: 606-723-5142
  • Fax: 606-723-3798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. VIVIAN ONG
Title or Position: OWNER
Credential: MD
Phone: 606-723-5142