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General NPI Number Information
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NPI Number | 1447185103
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Entity Type | Organization
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Legal Business Name | PREMIER KIDS PEDIATRIC URGENT CARE PLLC
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Dates
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Enumeration Date | 06/15/2026
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Last Update Date | 06/15/2026
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Provider Practice Location Address
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Address Line | 1728 PARK AVE NW
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City | NORTON
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State | VA
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Zip | 24273-1613
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Country | US
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Telephone | 276-327-7982
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Fax | 276-999-7699
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Provider Business Mailing Address
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Address Line | 1728 PARK AVE NW
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City | NORTON
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State | VA
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Zip | 24273-1613
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Country | US
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Telephone | 276-327-7982
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Fax | 276-999-7699
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL P. DEEL
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Credential | DO
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Telephone | 276-327-7982
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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