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General NPI Number Information
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NPI Number | 1962091504
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Entity Type | Organization
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Legal Business Name | INTOUCH PEDIATRICS CORPORATION
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Dates
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Enumeration Date | 01/17/2021
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Last Update Date | 01/17/2021
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Provider Practice Location Address
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Address Line | 2321 HENRY CLOWER BLVD STE A
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City | SNELLVILLE
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State | GA
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Zip | 30078-7419
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Country | US
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Telephone | 404-405-6860
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Fax |
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Provider Business Mailing Address
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Address Line | 3225 MCLEOD DR STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89121-2257
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELINDA WILLINGHAM
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Credential | MD
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Telephone | 404-842-5070
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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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