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General NPI Number Information
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NPI Number | 1295724680
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Entity Type | Organization
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Legal Business Name | THE CHILDREN'S DOCTORS PC
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Dates
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Enumeration Date | 10/18/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2366 BATTLEFIELD PKWY
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City | FORT OGLETHORPE
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State | GA
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Zip | 30742-4030
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Country | US
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Telephone | 706-866-7384
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Fax | 706-861-7003
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Provider Business Mailing Address
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Address Line | 2366 BATTLEFIELD PKWY
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City | FORT OGLETHORPE
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State | GA
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Zip | 30742-4030
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Country | US
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Telephone | 706-866-7384
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Fax | 706-861-7003
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BRENDA VANN
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Credential |
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Telephone | 706-866-7384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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