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General NPI Number Information
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NPI Number | 1366569485
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Entity Type | Organization
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Legal Business Name | BI-COUNTY PEDIATRICS
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6128 PRESTLEY MILL RD STE D
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-5622
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Country | US
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Telephone | 770-949-3888
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Fax | 770-949-3504
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Provider Business Mailing Address
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Address Line | 6128 PRESTLEY MILL RD STE D
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-5622
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Country | US
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Telephone | 770-949-3888
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Fax | 770-949-3504
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAYMOND P FLOWERS III
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Credential | D.O.
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Telephone | 770-949-3888
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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 | 020701
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License Number State | GA
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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 | 058682
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License Number State | GA
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