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General NPI Number Information
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NPI Number | 1083652630
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Entity Type | Organization
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Legal Business Name | PIEDMONT PEDIATRICS LLC
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 996 MEDICAL RIDGE ROAD
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City | CLINTON
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State | SC
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Zip | 29325
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Country | US
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Telephone | 864-833-5654
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Fax | 864-833-2786
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Provider Business Mailing Address
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Address Line | 996 MEDICAL RIDGE ROAD
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City | CLINTON
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State | SC
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Zip | 29325
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Country | US
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Telephone | 864-833-5654
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Fax | 864-833-2786
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KAREN NOLEN
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Credential |
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Telephone | 864-833-5654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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