Healthcare Provider Details

I. General information

NPI: 1447185103
Provider Name (Legal Business Name): PREMIER KIDS PEDIATRIC URGENT CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 PARK AVE NW
NORTON VA
24273-1613
US

IV. Provider business mailing address

1728 PARK AVE NW
NORTON VA
24273-1613
US

V. Phone/Fax

Practice location:
  • Phone: 276-327-7982
  • Fax: 276-999-7699
Mailing address:
  • Phone: 276-327-7982
  • Fax: 276-999-7699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL P. DEEL
Title or Position: OWNER
Credential: DO
Phone: 276-327-7982