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General NPI Number Information
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NPI Number | 1093700833
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Entity Type | Organization
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Legal Business Name | GOODLETTSVILLE PEDIATRICS, PC
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 3103 BUSINESS PARK CIR STE 100
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3676
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Country | US
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Telephone | 615-851-7865
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Fax | 615-851-7853
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Provider Business Mailing Address
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Address Line | 3103 BUSINESS PARK CIR STE 100
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City | GOODLETTSVILLE
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State | TN
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Zip | 37072-3676
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Country | US
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Telephone | 615-851-7865
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Fax | 615-851-7853
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. PATTY A SCHLEICHER
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Credential |
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Telephone | 615-851-7865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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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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