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General NPI Number Information
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NPI Number | 1376902262
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Entity Type | Organization
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Legal Business Name | PHYSICIANS FOR CHILDREN & ADOLESCENTS PSC
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Dates
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Enumeration Date | 02/19/2016
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 1330 S MAYO TRL SUITE 201
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City | PIKEVILLE
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State | KY
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Zip | 41501-2321
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Country | US
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Telephone | 606-432-0123
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Fax | 606-433-1414
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Provider Business Mailing Address
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Address Line | PO BOX 3339
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City | PIKEVILLE
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State | KY
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Zip | 41502-3339
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Country | US
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Telephone | 606-432-0123
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Fax | 606-433-1414
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. RAKESH SACHDEVA
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Credential | MD
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Telephone | 606-432-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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