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General NPI Number Information
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NPI Number | 1871292979
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Entity Type | Organization
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Legal Business Name | PEDIATRIC WORKS
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Dates
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Enumeration Date | 02/27/2023
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 6065 LAKE FORREST DR STE 250
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City | ATLANTA
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State | GA
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Zip | 30328-3868
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Country | US
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Telephone | 404-301-2191
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Fax | 404-301-4177
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Provider Business Mailing Address
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Address Line | 6065 LAKE FORREST DR STE 250
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City | ATLANTA
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State | GA
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Zip | 30328-3868
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Country | US
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Telephone | 404-301-2191
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Fax | 404-301-4177
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIMBERLY NICOLE WORKS
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Credential | MD
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Telephone | 404-301-2191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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