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NPI Code Detail

MEDICARE: THE CHILDREN'S DOCTORS PC

MEDICARE: THE CHILDREN'S DOCTORS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

General Provider Information

NPI Number : 1295724680
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CHILDREN'S DOCTORS PC
Provider Business Mailing Address
First Line : 2366 BATTLEFIELD PKWY
Second Line :
City : FORT OGLETHORPE
State : GA
Zip : 30742-4030
Country : US
Telephone Number : 706-866-7384
Fax Number : 706-861-7003
Provider Business Practice Location Address
First Line : 2366 BATTLEFIELD PKWY
Second Line :
City : FORT OGLETHORPE
State : GA
Zip : 30742-4030
Country : US
Telephone Number : 706-866-7384
Fax Number : 706-861-7003
Authorized Official
Title or Position : OFFICE MANAGER
Name : BRENDA VANN
Credential :
Telephone Number : 706-866-7384
Provider Enumeration Date : 10/18/2005
Last Update Date : 08/22/2020

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Directions to “THE CHILDREN'S DOCTORS PC ” Practice Location

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