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General NPI Number Information
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NPI Number | 1558500983
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Entity Type | Organization
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Legal Business Name | MILLEDGEVILLE PEDIATRICS PC
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Dates
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Enumeration Date | 02/09/2009
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Last Update Date | 08/08/2011
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Provider Practice Location Address
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Address Line | 750 N COBB ST STE 230
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-7162
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Country | US
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Telephone | 478-453-9383
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Fax | 478-452-1147
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Provider Business Mailing Address
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Address Line | 750 N COBB ST STE 230
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-7162
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Country | US
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Telephone | 478-453-9383
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Fax | 478-452-1147
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LAKEYCIA MICHELLE ROBINSON
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Credential |
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Telephone | 478-453-9383
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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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